Association between childhood trauma exposure and pro-inflammatory cytokines in schizophrenia and bipolar-I disorder

• Published in: Psychological medicine 2019-12, Vol.49 (16), p.2736-2744
• Main Authors: Quidé, Yann, Bortolasci, Chiara C, Spolding, Briana, Kidnapillai, Srisaiyini, Watkeys, Oliver J, Cohen-Woods, Sarah, Berk, Michael, Carr, Vaughan J, Walder, Ken, Green, Melissa J
• Format: Article
• Language: English
• Subjects: Abuse; Adverse childhood experiences; Bipolar disorder; C-reactive protein; Child abuse & neglect; Childhood; Children; Community health care; Cytokines; Diagnosis; Immune system; Inflammation; Interleukin 6; Medical diagnosis; Mental disorders; Necrosis; Psychological trauma; Psychosis; Psychotropic drugs; Questionnaires; Schizoaffective disorder; Schizophrenia; Serum; Serum levels; Sex crimes; Sexual abuse; Trauma; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Tumors
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291718003690

Elevated levels of pro-inflammatory cytokines are consistently reported in schizophrenia (SZ) and bipolar-I disorder (BD), as well as among individuals who have been exposed to childhood trauma. However, higher levels of inflammatory markers in these disorders are yet to be investigated with respect to levels of exposure to different types of childhood trauma. Participants were 68 cases with a diagnosis of schizophrenia/schizoaffective disorder (SZ), 69 cases with a diagnosis of psychotic BD and 72 healthy controls (HC). Serum levels of interleukin 6 (IL-6), tumour necrosis factor-α (TNF-α) and C-reactive protein (CRP) were quantified, and childhood trauma exposure was assessed with the Childhood Trauma Questionnaire. The SZ group had significantly higher levels of IL-6, TNF-α and CRP when compared with the HC group (all p < 0.05, d = 0.41-0.63), as well as higher levels of TNF-α when compared with the BD group (p = 0.014, d = 0.50); there were no differences between the BD and HC groups for any markers. Exposure to sexual abuse was positively associated (standardised β = 0.326, t = 2.459, p = 0.018) with levels of CRP in the SZ group, but there were no significant associations between any form of trauma exposure and cytokine levels in the HC or BD groups. These results contribute to the evidence for a chronic state of inflammation in SZ but not BD cases. Differential associations between trauma exposure and levels of pro-inflammatory cytokines across the diagnostic categories suggest that trauma may impact biological (stress and immune) systems differently in these patient groups.