C-reactive protein and agitation in patients with schizophrenia: A cohort study with a control group

Background. - Recent studies first reported the relevant role of the immune system in the pathophysiology of schizophrenia and then the association between inflammation and agitation. Objectives. - In this study, we aim to explore the relationship between CRP (C-reactive protein) levels and agitation in patients with schizophrenia. Methods. - We conducted a cohort study with a comparison group of 60 patients with a DSM5 diagnosis of schizophrenia who were followed by the Department of Psychiatry of the University Hospital of Marrakech in Morocco. Patients were divided into two groups according to the state of agitation evaluated by the PANSS Excitement scale. These two groups have been matched according to age and gender. A comparison of CRP level, clinical and laboratory characteristics between the two groups and a monitoring of CRP level in the agitated group after 3 weeks of treatment were performed. Results. - Inpatients with agitation displayed a significantly high CRP (P<0.0001), a high score of PANSS total (P<0.0001), PANSS positive (P<0.0001) and general PANSS (P < 0.0001). After treatment, there was a significant reduction in CRP (P<0.0001) and PANSS excitement (P<0.0001). Conclusion. - These results confirm the role played by inflammation and immunity in agitation behavior in patients with schizophrenia and highlight the interest of the CRP assay at the time of admission of patients as a potential marker of agitation in hospitalized patients with schizophrenia. (C) 2020 L'Encephale, Paris.