Longitudinal association between CRP levels and risk of psychosis: a meta-analysis of population-based cohort studies.


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Authors
Baxter, Luke 
Stochl, Jan 
Perry, Benjamin I 
Abstract

Meta-analyses of cross-sectional studies suggest that patients with psychosis have higher circulating levels of C-reactive protein (CRP) compared with healthy controls; however, cause and effect is unclear. We examined the prospective association between CRP levels and subsequent risk of developing a psychotic disorder by conducting a systematic review and meta-analysis of population-based cohort studies. Databases were searched for prospective studies of CRP and psychosis. We obtained unpublished results, including adjustment for age, sex, body mass index, smoking, alcohol use, and socioeconomic status and suspected infection (CRP > 10 mg/L). Based on random effect meta-analysis of 89,792 participants (494 incident cases of psychosis at follow-up), the pooled odds ratio (OR) for psychosis for participants with high (>3 mg/L), as compared to low (≤3 mg/L) CRP levels at baseline was 1.50 (95% confidence interval [CI], 1.09-2.07). Evidence for this association remained after adjusting for potential confounders (adjusted OR [aOR] = 1.31; 95% CI, 1.03-1.66). After excluding participants with suspected infection, the OR for psychosis was 1.36 (95% CI, 1.06-1.74), but the association attenuated after controlling for confounders (aOR = 1.23; 95% CI, 0.95-1.60). Using CRP as a continuous variable, the pooled OR for psychosis per standard deviation increase in log(CRP) was 1.11 (95% CI, 0.93-1.34), and this association further attenuated after controlling for confounders (aOR = 1.07; 95% CI, 0.90-1.27) and excluding participants with suspected infection (aOR = 1.07; 95% CI, 0.92-1.24). There was no association using CRP as a categorical variable (low, medium or high). While we provide some evidence of a longitudinal association between high CRP (>3 mg/L) and psychosis, larger studies are required to enable definitive conclusions.

Description
Keywords
32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, Brain Disorders, Serious Mental Illness, Clinical Research, Mental Health, 3 Good Health and Well Being
Journal Title
NPJ Schizophr
Conference Name
Journal ISSN
2334-265X
2334-265X
Volume Title
7
Publisher
Springer Science and Business Media LLC
Rights
All rights reserved
Sponsorship
Wellcome Trust (201486/Z/16/Z)
Medical Research Council (MC_PC_17213)
Medical Research Council (MR/S037675/1)
Wellcome Trust (095844/Z/11/Z)
Wellcome Trust (088869/Z/09/Z)
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (RP PG-0616-20003)
MQ: Transforming Mental Health (MQDS17\40)
NIHR