Samples

Specimens came from the blood bank at the Department of Psychiatry, University of Magdeburg, Germany,^15–17 and were collected from sequentially admitted acutely ill psychotic inpatients (February 2008 to June 2018; n = 253). FEP patients (n = 129) were drug-naïve at baseline (T0) and non-first-episode Sz patients (n = 124) were unmedicated ≥6 weeks. Controls (n = 294; healthy blood donors and hospital staff and their relatives) came from the same collection period (see table 1).

Demographic Data

Note: Data presented as median (quartile 1; quartile 3; sample size). BMI, body mass index; CRP, C-reactive protein; FEP, first-episode psychosis; PANSS, Positive and Negative Syndrome Scale; Sz, schizophrenia; T0, acutely ill unmedicated; T6, after 6 weeks of treatment.

*P < .05, **P < .01, ***P < .001.

Exclusion criteria were cannabis consumption or other substance abuse, psychosis induced by other medical conditions, a history of immune disease or immunotherapy.¹⁶ Controls were screened for personal or family history of neuropsychiatric disorders using the Mini-International Neuropsychiatric Interview.¹⁸ Procedures were approved by the local institutional review board and written informed consent was obtained.

Blood analyses and psychopathological assessments (PANSS) were performed at baseline. Follow-up assessments after 6 weeks (T6) were available for 175 patients. The types and cumulative dosages of antipsychotic drugs taken from baseline to follow-up were documented and converted into chlorpromazine (CPZ) equivalents.^19–21 A total of 163 subjects were medicated for 6 weeks after baseline assessment (olanzapine: n = 71; quetiapine: n = 17; risperidone: n = 45; aripiprazole: n = 15; typical antipsychotic drugs: n = 9; other drugs/combinations: n = 6). Blood samples were obtained from fasting subjects at 08:00 am and collected into BD Vacutainer tubes (Becton Dickinson). Ethylenediamine tetraacetic acid-blood tubes were used for determining differential blood counts within 1 h. Serum tubes were centrifuged at 1000g for 10 min after 2 h clotting. Supernatants were aliquoted and stored at −80°C.