Evidence map›Paper›PMID 35202480›Full record

SynthesisActa psychiatrica Scandinavica2022

Inflammation in first-episode psychosis: The contribution of inflammatory biomarkers to the emergence of negative symptoms, a systematic review and meta-analysis.

Connor Dunleavy, Richard J Elsworthy, Rachel Upthegrove, Stephen J Wood, Sarah Aldred

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta psychiatrica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 107 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
107citing papers in PubMed, 8 pooled it
9.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

107 citing papers in PubMed, 8 syntheses or guidelines pooled it, 154 citations in OpenAlex.

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  19. Causal links among gut microbiota, immune-inflammatory and compensatory immune-regulatory systems, and schizophrenia.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
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47 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Connor DunleavySchool of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.ORCID 0000-0003-2340-9012
Richard J ElsworthySchool of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Rachel UpthegroveSchool of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK.
Stephen J WoodSchool of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Sarah AldredSchool of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
University of Birmingham · GBBirmingham Women’s and Children’s NHS Foundation Trust · GBThe University of Melbourne · AU

Funding

Medical Research Council MR/S037675/1
6 · The paper itself

Abstract

objectiveTo provide a comprehensive analysis of cytokine perturbations in antipsychotic-naïve first-episode psychosis (FEP) populations and assess the relationship between inflammatory biomarkers and negative symptom severity.

methodsA systematic review and meta-analysis following PRISMA guidelines were conducted. A total of 1042 records were identified via systematic search of EMBASE, MEDLINE and APA PsycInfo databases. Sixteen studies met the inclusion criteria and were eligible for inclusion in the review. Ten of these studies had sufficient data for inclusion in a random effects, pooled-effect meta-analysis.

resultsA significant and large effect size was reported for IFN-γ, IL-6 and IL-12, and a moderate effect size reported for IL-17 (p = <0.05) in people with antipsychotic naive first episode psychosis, compared to healthy controls, suggesting a significant elevation in proinflammatory cytokine concentration. Non-significant effect sizes were reported for TNF-α, IL-1β, IL-2, IL-4, IL-8 and IL-10 (p = >0.05). Regarding proinflammatory cytokines and relationships to negative symptomology, moderate positive relationships were reported for negative symptoms and IL-1β, IL-2, IL-6 and TNF-α, across four studies. For anti-inflammatory cytokines, one strong and one weak-to-moderate negative relationship was described for IL-10 and negative symptoms. Contrastingly, a strong positive relationship was reported for IL-4 and negative symptoms.

conclusionThere is evidence of significantly elevated proinflammatory cytokines in antipsychotic-naïve FEP populations, alongside promising findings from cohort data suggesting an interaction between inflammation and primary negative symptomology. Future studies should seek to come to a consensus on a panel of cytokines that relate most specifically to negative symptoms, and consider longitudinal studies to investigate how cytokine fluctuations may relate to exacerbation of symptoms.

Indexed as

Antipsychotic AgentsPsychotic DisordersBiomarkersCytokinesHumansInflammationInterleukin-10Interleukin-2Interleukin-4Interleukin-6Tumor Necrosis Factor-alphaAntipsychotic AgentsBiomarkersCytokinesInterleukin-10Interleukin-2Interleukin-4Interleukin-6Tumor Necrosis Factor-alphacytokinesimmune responseinflammationnegative symptomsschizophrenia

Identifiers

PMID35202480
PMCPMC9310618
OpenAlexW4213436284

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.