Background
Methods
Data extraction
-
Inpatients
-
At least one admission in our tertiary care hospital
-
ICD-10 diagnosis of a first-episode F2x (schizophrenia-spectrum). In this context, patients admitted with a diagnosis of drug-induced FEP, which subsequently received a schizophrenia-spectrum diagnosis within the above mentioned time period for the analyses, were also included
-
Available data for CSF/serum albumin quotients and at least one assessment of vitamin levels (folate or vitamin B12) within 60 days around the time point of the lumbar puncture
CSF and blood-based vitamin levels
Demographic and clinical information (n = patients included in analyses) | Complete cohort (n = 222) | Vitamin B12 OR Folate decreased (n = 39) | Vitamin B12 AND Folate within range (n = 183) | Vitamin deficiencies vs vitamins within range | ||
---|---|---|---|---|---|---|
Mean ± SD | Mean ± SD (n) | Mean ± SD (n) | Z | df | p | |
Mean age at time of lumbar puncture (years) (n = 222) | 34.89 ± 15.77 | 35.90 ± 17.65 (n = 39) | 34.67 ± 15.38 (n = 183) | −0.19 | 1 | 0.851a |
Mean duration between first symptoms and lumbar puncture (months) (n = 140) | 13.37 ± 25.35 | 21.70 ± 47.74 (n = 27) | 11.38 ± 15.74 (n = 113) | −0.73 | 1 | 0.466a |
% (absolute) | % (absolute) | % (absolute) | χ2 | df | p | |
---|---|---|---|---|---|---|
Gender (female/male) (n = 222) | 46.40/53.60 (103/119) | 43.59/56.41 (17/22) | 46.99/53.01 (86/97) | 0.15 | 1 | 0.699 |
Diagnosis* (n = 222) | ||||||
Schizophrenia (ICD-10: F20) | 46.40 (103) | 41.03 (16) | 47.54 (87) | 6.34 | 5 | 0.275 |
Schizotypal disorder (ICD-10: F21) | 3.15 (7) | 7.69 (3) | 2.19 (4) | |||
Persistent delusional disorder (ICD-10: F22) | 8.11 (18) | 5.13 (2) | 8.74 (16) | |||
Acute and transient psychotic disorder (ICD-10: F23) | 22.97 (51) | 17.95 (7) | 24.04 (44) | |||
Schizoaffective disorder (ICD-10: F25) | 9.01 (20) | 12.82 (5) | 8.20 (15) | |||
Others | 10.36 (23) | 15.38 (6) | 9.29 (17) | |||
Antipsychotic treatment (n = 210) | 96.67 (203) | 100 (37) | 95.95 (166) | 1 | 0.252b | |
Antipsychotic treatment with 1 AP (n = 210) | 69.05 (145) | 75.68 (28) | 67.63 (117) | 0.92 | 1 | 0.337 |
Antipsychotic treatment with 2 or more APs (n = 210) | 27.62 (58) | 24.32 (9) | 28.33 (49) | 0.24 | 1 | 0.621 |
Positive family history for psychiatric illnesses (n = 204) | 51.47 (105) | 42.86 (15) | 53.25 (90) | 1.25 | 1 | 0.263 |
Comorbidities | ||||||
Neurological comorbidity (n = 222) | 9.91 (22) | 15.38 (6) | 8.74 (16) | 1.59 | 1 | 0.208 |
Diabetes type I or II (n = 222) | 4.50 (10) | 5.13 (2) | 4.37 (8) | 1 | 0.689b | |
Cardiovascular disease (n = 220) | 15.45 (34) | 15.38 (6) | 15.47 (28) | < 0.01 | 1 | 0.989 |
Cancer (n = 219) | 8.22 (18) | 10.53 (4) | 7.73 (14) | 1 | 0.525b | |
Lung disease (n = 221) | 8.14 (18) | 10.26 (4) | 7.69 (14) | 1 | 0.532b | |
Active smoker (n = 215) | 34.42 (74) | 43.24 (16) | 32.58 (58) | 1.54 | 1 | 0.214 |
Active drug abuse (at least 1 psychotropic substance)** (n = 219) | 29.22 (64) | 25.64 (10) | 30 (54) | 0.29 | 1 | 0.587 |
Cannabis abuse (n = 222) | 16.67 (37) | 17.95 (7) | 16.39 (30) | 0.06 | 1 | 0.813 |
Vitamin serum levels | Mean ± SD | Mean ± SD (n) | Mean ± SD (n) |
---|---|---|---|
Vitamin B12 level pg/ml (n = 222) | 481.98 ± 261.87 | 203.65 ± 36.62 (n = 23) | 514.15 ± 257.60 (n = 199) |
Folate level ng/ml (n = 217) | 9.46 ± 4.74 | 7.12 ± 4.71 (n = 22) | 9.73 ± 4.68 (n = 195) |
% (absolute) | |
---|---|
Vitamin B12 decreased**** (n = 222) | 10.36 (23) |
Folate decreased*** (n = 217) | 11.06 (24) |
Vitamin B12 OR Folate decreased**** (n = 222) | 17.57 (39) |
Cerebrospinal fluid assessment | Mean ± SD | Mean ± SD (n) | Mean ± SD (n) | Z | df | p |
---|---|---|---|---|---|---|
Albumin level, g/l (n = 222) | 0.25 ± 0.11 | 0.22 ± 0.08 (n = 39) | 0.25 ± 0.12 (n = 183) | −0.89 | 1 | 0.373a |
Qalb (CSF/serum) (n = 222) | 5.47 ± 2.40 | 5.08 ± 1.74 (n = 39) | 5.56 ± 2.51 (n = 183) | −0.71 | 1 | 0.479a |
IgG, g/l (n = 221) | 0.03 ± 0.02 | 0.03 ± 0.03 (n = 38) | 0.03 ± 0.02 (n = 183) | −1.30 | 1 | 0.194a |
IgG ratio (CSF/serum) (n = 221) | 2.79 ± 2.06 | 3.14 ± 4.23 (n = 38) | 2.71 ± 1.21 (n = 183) | −0.43 | 1 | 0.670a |
Total protein level, g/l (n = 222) | 0.38 ± 0.27 | 0.44 ± 0.57 (n = 39) | 0.37 ± 0.14 (n = 183) | −0.27 | 1 | 0.785a |
Number of cells, /µL (n = 222) | 1.58 ± 1.91 | 1.31 ± 1.47 (n = 39) | 1.63 ± 2 (n = 183) | −1.23 | 1 | 0.220a |
% (absolute) | % (absolute) | % (absolute) | χ2 | df | p | |
---|---|---|---|---|---|---|
Altered Qalb*** (n = 222) | 17.12 (38) | 7.69 (3) | 19.13 (35) | 1 | 0.103b | |
Oligoclonal bands (n = 171) | ||||||
No oligoclonal bands, type 1 | 72.51 (124) | 72.73 (24) | 72.46 (100) | 0.08 | 3 | 0.994 |
Oligoclonal bands type 2 | 2.92 (5) | 3.03 (1) | 2.90 (4) | |||
Oligoclonal bands type 3 | 8.19 (14) | 9.09 (3) | 7.97 (11) | |||
Oligoclonal bands type 4 | 16.37 (28) | 15.15 (5) | 16.67 (23) | |||
Oligoclonal bands type 5 | 0 (0) |
Brain MRI | % (absolute) | % (absolute) | % (absolute) | χ2 | df | p |
---|---|---|---|---|---|---|
Any brain MRI pathologies (n = 212) | 40.09 (85) | 44.74 (17) | 39.08 (68) | .42 | 1 | 0.519 |
WML(s) (n = 212) | 29.25 (62) | 36.80 (14) | 27.60 (48) | 1.29 | 1 | 0.256 |
Lesion(s) suggestive of MS (n = 212) | 1.89 (4) | 0 (0) | 2.3 (4) | 1 | 1b |