B2819 - Markers of prediabetes psychotic experiences and inflammation A cohort study from ALSPAC - 12/07/2017

B number: 
B2819
Principal applicant name: 
Benjamin Ian Perry | 1) Coventry and Warwickshire Partnership NHS Trust 2) Department of Mental Health and Wellbeing, University of Warwick (UK)
Co-applicants: 
Dr Rachel Upthegrove, Dr Andrew Thompson, Dr Steven Marwaha, Dr Golam Khandaker, Professor Stan Zammit
Title of project: 
Markers of prediabetes, psychotic experiences and inflammation: A cohort study from ALSPAC
Proposal summary: 

Patients with schizophrenia have shortened life expectancy, with mortality rates twice that of the general population. Causes for this extend beyond suicide, accidents and risk-taking behaviour. Research indicates that physical illnesses, including heart disease and type 2 diabetes mellitus (T2DM) account for a majority of the increased mortality risk. The prevalence of T2DM in schizophrenia is increased by around one-third compared with the general population.

There is a growing body of research to suggest that links between the two illnesses may go deeper than the previously assumed - related solely due to either a side-effect of medications used to treat schizophrenia, reduced access to healthcare in patients with schizophrenia, and poor diet/sedentary lifestyle. A recent meta-analysis in Lancet Psychiatry by the lead proposal author has shown that participants with first-episode psychosis (the first time a generally younger person goes to hospital with symptoms of schizophrenia) are more likely to have signs of early diabetes than healthy matched controls. All participants in the meta-analysis had very limited exposure to antipsychotic medication, reducing the impact of the potential confounder.

There is a growing body of work showing that both schizophrenia and diabetes may indeed feature an inflammatory component, and this may be shared. The inflammatory component in patients with a potentially earlier form of schizophrenia - termed 'psychotic experiences', has previously been examined in the ALSPAC cohort by one of the proposal authors, with positive findings.

It would therefore be of great interest to examine whether any possible disease link begins earlier than the 'first psychotic episode', by examining patients suffering 'psychotic experiences'. With the noted possible inflammatory disease links between diabetes and schizophrenia, it would be of great interest to examine whether those with psychotic experiences and abnormal inflammatory profiles also have abnormal glycaemic indices.

Finally, it would be interesting to examine whether markers of early diabetes can predict the onset of psychotic experiences.

Date proposal received: 
Saturday, 14 January, 2017
Date proposal approved: 
Thursday, 19 January, 2017
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Diabetes, Mental health, Statistical methods, Biological samples -e.g. blood, cell lines, saliva, etc., Biomarkers - e.g. cotinine, fatty acids, haemoglobin, etc., BMI, Cohort studies - attrition, bias, participant engagement, ethics, Endocrine - endocrine disrupters, Hormones - cortisol, IGF, thyroid, Immunity, Metabolic - metabolism, Methods - e.g. cross cohort analysis, data mining, mendelian randomisation, etc.