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https://doi.org/10.24869/spsih.2026.162

Markers of Low-Grade Inflammation in Patients With First-Episode Psychosis: A Retrospective-Prospective Observational Study—Preliminary Results

Emio Halilović ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia *
Elizabeth Nedić ; Department for Psychiatry, „Dr. Juraj Njavro” National Memorial Hospital Vukovar, Županijska ulica 35, 32000 Vukovar, Croatia
Paula Marinović ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Ana Lončar Vrančić ; Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Zoran Štimac ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Dunja Rogić ; Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Marina Šagud ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Šalata 3b, 10000 Zagreb, Croatia
Alma Mihaljević-Peleš ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Maja Živković ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Šalata 3b, 10000 Zagreb, Croatia

* Corresponding author.


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Abstract

Introduction and aim of the study: Psychotic disorders
are characterized by the presence of positive,
negative, and cognitive symptoms. First-episode
psychosis (FEP) most commonly occurs between
15 and 30 years of age. The etiopathogenesis
of FEP is complex and multifactorial, resulting
from genetic predisposition, structural brain
changes, neurotransmitter alterations, neuroinflammation,
and environmental factors. Although
numerous studies indicate an association between schizophrenia and low-grade inflammation, there
is a lack of such studies in patients with FEP. The
main aim of this study is to determine the presence
of neuroinflammation in patients with FEP
(diagnosis according to the International Classification
of Diseases, 10th revision: F23) and to
compare the level of inflammatory markers with
a healthy control group. Materials and methods:
This retrospective–prospective observational
study is being conducted at the Department of
Psychiatry and Psychological Medicine of University
Hospital Centre Zagreb. The study was
approved by the Ethics Committee of University
Hospital Centre Zagreb. The following markers
of neuroinflammation were measured: C-reactive
protein (CRP), neutrophil-to-lymphocyte ratio
(NLR), monocyte-to-lymphocyte ratio (MLR),
platelet-to-lymphocyte ratio (PLR), and systemic
immune-inflammation index (SII). Statistical
analysis: Demographic characteristics of participants
and values of inflammatory indicators were
presented using descriptive statistics. To compare
the control group and the FEP group, the Mann–
Whitney U test was applied in the statistical program
JAMOVI, version 2.7.30. Results: The study
included 53 patients with FEP and 62 healthy
individuals in the control group. Patients with
FEP had statistically significantly higher values of
NLR, MLR, SII, and CRP, with a moderate to large
effect size. No statistically significant difference in
PLR values was observed between groups. Conclusion:
The results of the study indicate the presence
of increased neuroinflammation in patients with a
first psychotic episode. Further research is needed
to clarify more precisely the role of neuroinflammatory
processes in the etiopathogenesis of FEP.

Keywords

C-reactive protein; complete blood count; neuroinflammation; psychotic disorders

Hrčak ID:

352274

URI

https://hrcak.srce.hr/352274

Publication date:

15.6.2026.

Article data in other languages: croatian

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