A Comparison of the Relationship Between C-Reactive Protein Levels and Cognitive Functions in Patients with Schizophrenia, First-Episode Psychosis, and Healthy Controls

Background: There are several hypotheses on what causes schizophrenia, some of which include inflammatory responses. Additionally, it might be challenging to control and treat cognitive abnormalities, which represent the primary symptoms, and may be related to inflammation. This study aims to determine whether there is a relationship between C-reactive protein levels and cognitive abilities by assessing neuropsychological tests of drug-free patients with schizophrenia and firstepisode psychosis.

Methods: The patient group consisted of 36 patients with schizophrenia or “first-episode psychosis,” while the control group comprised 31 healthy people. The control group consisted of healthy participants without any medical or psychiatric diseases. Structured Clinical Interview for DSM-5 axis I disorders was applied for diagnosis, while Wisconsin card sorting test, Stroop color and word test, trail making tests, Rey auditory verbal learning test, and digit span test were applied for cognitive assessment of both groups. Clinical characteristics of patients were evaluated by using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Calgary Depression Scale for Schizophrenia. The patient group and healthy control group were evaluated in terms of inflammation levels. The C-reactive protein levels were measured, and their relationship with cognitive status was examined. The serum samples were analyzed by the immunoturbidimetric method in C-reactive protein C8000 Architect (Abbott, Ill, USA) to measure the C-reactive protein levels.

Results: C-reactive protein levels were found to be higher in the patient group (P=.003), while the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms scores were found to be positively correlated with C-reactive protein levels. Cognitive functions in the patient group were significantly lower compared to the healthy group. There was a statistically weak correlation between C-reactive protein and the number of word color reading errors in the Stroop test, which was associated with complex and frontal attention; however, no correlation was found with digit span test, Rey auditory verbal learning test, or Wisconsin card sorting test points.

Conclusion: Elevated peripheral levels of C-reactive protein are associated with poorer cognitive function in patients with first-episode psychosis and schizophrenia, particularly, complex attention associated with the Stroop test. Inflammation may have an impact on cognitive impairment in psychosis.

Cite this article as: Demir N, Yıldırım O. A comparison of the relationship between C-reactive protein levels and cognitive functions in patients with schizophrenia, first-episode psychosis, and healthy controls. Psychiatry Clin Psychopharmacol. 2022;32(4):274-284.