Childhood maltreatment is associated with increased body mass index and increased C-reactive protein levels in first-episode psychosis patients

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Abstract

Background. The high incidence of the metabolic syndrome in patients with psychosis is mainly attributed to antipsychotic treatment. However, it is also possible that psychological stress plays a role, inducing a chronic inflammatory process that may predispose to the development of metabolic abnormalities. We investigated the association between childhood maltreatment and inflammatory and metabolic biomarkers in subjects with first-episode psychosis and healthy controls.

Method. Body mass index (BMI), weight and waist circumference were measured in 95 first-episode psychosis patients and 97 healthy controls. Inflammatory and metabolic markers were measured in a subsample of 28 patients and 45 controls. In all the subjects we collected information on childhood maltreatment and recent stressors.

Results. Patients with childhood maltreatment had higher BMI [25.0 (S.E. = 0.6) kg/m(2)] and C-reactive protein (CRP) levels [1.1 (S.E. = 0.6) mg/dl] when compared with healthy controls [23.4 (S.E. = 0.4) kg/m(2), p = 0.030 and 0.2 (S.E. = 0.1) mg/dl, p = 0.009, respectively]. In contrast, patients without childhood maltreatment were not significantly different from healthy controls for either BMI [24.7 (S.E. = 0.6) kg/m(2), p = 0.07] or CRP levels [0.5 (S.E. = 0.2) mg/dl, p = 0.25]. After controlling for the effect of BMI, the difference in CRP levels across the three groups remained significant (F-2,F-58 = 3.6, p = 0.035), suggesting that the increase in inflammation was not driven by an increase in adipose tissue.

Conclusions. Childhood maltreatment is associated with higher BMI, and increased CRP levels, in patients with a first-episode psychosis. Further studies need to confirm the mechanisms underlying the putative causal relationship between childhood maltreatment and higher BMI, and whether this is indeed mediated by increased inflammation.

Original languageEnglish
Pages (from-to)1893-1901
Number of pages9
JournalPsychological Medicine
Volume42
Issue number9
Early online date20 Jan 2012
DOIs
Publication statusPublished - Sept 2012

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