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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

Assessing and managing inflammation will contribute to the diagnosis and treatment of psychiatric disorders

Assessment and management of inflammation will benefit diagnosis and treatment of psychiatric disorders

Inflammation measured by CRP is insufficient to distinguish between psychiatric diagnoses, but it has the potential to guide treatment selection by identifying inflammation-enriched subgroups.

The study aimed to examine the utility of inflammation measured by C-reactive protein (CRP) in distinguishing psychiatric diagnoses and guiding treatment selection, using two synthesis approaches. In terms of methods, 34 published meta-analyses were used to obtain pooled estimates of plasma CRP differences between patients and controls within each diagnostic category; separately, a PRISMA-ScR-compliant scoping review was conducted, covering 89 studies that stratified patients within diagnoses by CRP. Across a total of 108 studies, CRP was elevated in patients compared with controls across six DSM diagnoses (g = 0.64, 95% confidence interval 0.53 to 0.76; I² = 0%), and this signal was found to be reproducible but not diagnostically discriminative. CRP was found to be higher in clinically ascertained samples (in schizophrenia, clinical sample g = 0.80, community sample g = 0.18, p = 0.042), indicating an association with more severe pathology. The prediction of a blunted response to SSRIs and a significant response to augmentation with anticytokine therapy (infliximab) and dopamine agonists (bupropion, levodopa) pointed to the value of enriching samples based on baseline inflammation (number needed to treat = 8.6). Mechanistic studies converge on a pharmacologically modifiable dysfunction in frontostriatal circuitry associated with anhedonia. In conclusion, inflammatory mechanisms are presented as modifiable, transdiagnostic pathologies that produce circuit-specific symptoms, such as anhedonia and avolition, in subgroups within diagnostic categories; prospective trials enrolling patients at prespecified inflammatory thresholds, randomizing them between active treatments, and measuring target engagement are needed to complete the translation into clinical practice.

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