Early versus late stage schizophrenia. What markers make the difference?

Abstract

Objectives: To identify the psychopathological, cognitive, functional, physical health and inflammatory markers that differentiate between early-stage schizophrenia (ESSCH) and late-stage schizophrenia (LSSCH).

Methods: Cross-sectional, naturalistic study of 104 patients with SCH. The sample was divided in two groups: 35 ESSCH (≤7 years’ duration of illness) and 69 LSSCH (>10 years’ duration of illness). Statistical analysis: chi-square test and Student's t-test and ANCOVA (or Quade test) controlling for age, sex, BMI and number of cigarettes/day. Finally, a binomial logistic regression was made.

Results: ESSCH show greater negative symptom severity (t = 2.465, p = 0.015), lower levels of IκBα (F = 7.644, p = 0.007), were more frequently classified as normal weight (40% vs 18.8%, p = 0.032) compared with LSSCH. The binomial logistic regression model included age (B = 0.127, p = 0.001) and IκBα (B = 0.025, p = 0.002) and accounted for 38.9% of the variance (model df =7, chi-square =41.841, p < 0.0001).

Conclusions: Age and IκBα are the unique markers that differentiate between ESSCH patients whose duration of illness is less than 7 years and LSSCH patients. These results support the hypothesis of toxicity of episodes and highlight the importance of preventing new episodes.

Keywords:

• Early-stage schizophrenia
• late-stage schizophrenia
• psychopathology
• functioning
• biomarkers

Acknowledgements

The authors wish to thank Sandra Rodríguez-Maus for her excellent technical assistance and Sharon Grevet for her English assistance. They were sponsored by research grants.

Statement of interest

Julio Bobes has received research grants and served as a consultant, advisor, or speaker for the following companies: AB-Biotics, Adamed, Almirall, AstraZeneca, Bristol-Myers Squibb, Ferrer, Glaxo- Smith-Kline, Hoffman La Roche, Janssen-Cilag, Lilly, Lundbeck, Merck, Novartis, Organon, Otsuka, Pfizer, Pierre-Fabre, Sanofi-Aventis, Servier, Shering-Plough and Shire, research funding from the Spanish Ministry of Economy and Competiveness – Centro de Investigación Biomedica en Red area de Salud Mental (CIBERSAM) and Instituto de Salud Carlos III, Spanish Ministry of Health, Social Services and Equality – National Drug Plan, and the 7th Framework Programme of the European Union.

Leticia Garcia-Alvarez has received honoraria from the 7th Framework Programme of the European Union and has served as a speaker for Pfizer and Janssen.

Maria Paz Garcia-Portilla has been a consultant to and/or has received honoraria/grants from Otsuka-Lundbeck Alliance, CIBERSAM, European Union (7th Framework Programme), Hoffman La Roche, Instituto de Salud Carlos III, Janssen-Cilag, Lilly, Lundbeck, Otsuka, Pfizer, Servier, Roche, and Rovi.

Celso Iglesias-García has received grants/research support from Esteve, Grupo Ferrer Internacional, S.A., Otsuka Pharmaceuticals SA, Pfizer SLU, and Roche Farma, S.A.

Leticia González Blanco has received a grant from the Spanish Foundation of Psychiatry and Mental Health, as well as speaker fees and travel expenses for attending conferences from Janssen-Cilag, Otsuka, Lundbeck, and Pfizer.

Pilar A. Sáiz has been a consultant to or has received honoraria or grants from Adamed, AstraZeneca, Brain Pharma, Bristol-Myers Squibb, CIBERSAM, Esteve, European Commission, Ferrer inCode, GlaxoSmithKline, Instituto de Salud Carlos III, Janssen-Cilag, Lilly, Lundbeck, Otsuka, Pfizer, National Drug Plan, Rovi and Servier.

All other researchers report no biomedical financial interests or potential conflicts of interest.

JRC is a postdoctoral Ramón y Cajal Researcher (Spanish Ministry of Economy, Industry and Competitiveness).

Additional information

Funding

This work was partly supported by the CIBERSAM, the Spanish Ministry of Economy and Competitiveness (MINECO-SAF 2016/75500-R to JCL), Instituto de Salud Carlos III (Ref. PI13/02263 to JB and PI1402037 to PGP), and Fondos Europeos de Desarrollo Regional (FEDER).