Inflammation in psychiatric disorders: what comes first?
Open accessAbstract
Neuropsychiatric disorders (i.e., mood disorders and schizophrenia) and inflammation are closely intertwined, and possibly powering each other in a bidirectional loop. Depression facilitates inflammatory reactions and inflammation promotes depression and other neuropsychiatric disorders. Patients with neuropsychiatric disorders exhibit all cardinal features of inflammation, including increased circulating levels of inflammatory inducers, activated sensors, and inflammatory mediators targeting all tissues. Inflammation may contribute to the pathophysiology and clinical progression of these disorders. Of note, proinflammatory cytokines modulate mood behavior and cognition by reducing brain monoamine levels, activating neuroendocrine responses, promoting excitotoxicity (increased glutamate levels), and impairing brain plasticity. What are the sources of this chronic inflammation? Increasing evidence indicates that changes in neuroendocrine regulation, metabolism, diet/microbiota, and negative health behaviors are important triggers of inflammation. Finally, recent data indicate that early‐life stress is associated with overt inflammation prior to the development of neuropsychiatric disorders.
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Patients with schizophrenia and bipolar disorder have increased levels of pro-inflammatory cytokines, oxidative stress products, chemokines, and soluble adhesion molecules in peripheral blood and cerebrospinal fluid.
“Patients with SCZ and BD have been consistently shown to present with increased levels of pro-inflammatory cytokines, oxidative stress products, chemokines, and soluble adhesion molecules both in the peripheral blood and the cerebrospinal fluid (14, 15).”
From Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder (2022) · cites this paper as [15]
In “Inflammation in neuropsychiatric disorders: inducers, sensors, and mediators” (page not provided), the paper reports elevated pro-inflammatory cytokines, chemokines, and soluble adhesion molecules in patients with bipolar disorder and schizophrenia, including in peripheral blood and cerebrospinal fluid. Table 1 lists increased oxidative stress markers in peripheral blood, but does not establish increased oxidative stress products in cerebrospinal fluid for those patients. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEvidence of altered inflammation-related markers across psychiatric conditions, anti-inflammatory effects of psychotropic medications, and ameliorative impact of anti-inflammatory drugs on psychiatric symptoms suggests a strong link between abnormal inflammatory responses and major psychiatric disorders.
“Evidence of altered inflammation-related markers across psychiatric conditions [6–8], along with reports of anti-inflammatory effects from psychotropic medications [9, 10] and the ameliorative impact of anti-inflammatory drugs on psychiatric symptoms [11–14], suggests a strong link between abnormal inflammatory responses and major psychiatric disorders.”
From Inflammatory ratios as predictors of length of hospitalization in psychiatric patients: A multicenter study (2025) · cites this paper as [6]
Elevated levels of pro-inflammatory cytokines, oxidative stress markers, chemokines, and soluble adhesion molecules have been observed at higher concentrations in blood and cerebrospinal fluid of individuals with schizophrenia and bipolar disorder.
“Elevated levels of pro-inflammatory cytokines, oxidative stress markers, chemokines, and soluble adhesion molecules have been observed with higher concentrations in the blood and cerebrospinal fluid of individuals with SCZ and BD (12).”
From Retrospective evaluation of novel serum inflammatory biomarkers in first-episode psychiatric disorders: diagnostic potential and immune dysregulation (2024) · cites this paper as [12]
Many psychiatric disorders have been linked to inflammation and an increased immune response, as observed through elevated levels of immune marker cytokines.
“Many psychiatric disorders have been linked to inflammation and an increased immune response, as observed through elevated levels of immune marker cytokines [57].”
From Effect of fecal microbiota transplant on symptoms of psychiatric disorders: a systematic review (2020) · cites this paper as [57]
Changes of some inflammation-related factors (IRFs) have been intensively studied and reviewed in relation to psychiatric disorders.
“Changes of some inflammation-related factors (IRFs) have been intensively studied and reviewed in relation to psychiatric disorders1–9.”
From Inflammation-related biomarkers in major psychiatric disorders: a cross-disorder assessment of reproducibility and specificity in 43 meta-analyses (2019) · cites this paper as [8]
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“In psychoneuroimmunology and biological psychiatry, inflammation has been tightly linked to neurocognitive processes and behavioral traits (Bauer and Teixeira 2018; Raison and Miller 2011).”
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- Authors
- Bauer, M. E., & Teixeira, A. L.
- Affiliations
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (BR)
- Department of Psychiatry and Behavioral Sciences The University of Texas Health Science Center at Houston Houston Texas
- Corresponding author
- Bauer, Moisés E.
- ORCID
- Bauer, Moisés E.
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2018-05-11
- Volume
- 1437
- Issue
- 1
- Pages
- 57-67
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- OpenAlex
- W2802032956
- Cited by
- 500
- References
- 76
- Citations by year
- 2026: 43 · 2025: 83 · 2024: 89 · 2023: 62 · 2022: 72 · 2021: 58 · 2020: 63 · 2019: 23 · 2018: 7
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the New York Academy of Sciences (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- PUCRS Repository (Pontifical Catholic University of Rio Grande do Sul) (submittedVersion, cc-by-nc-sa)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (304528/2013‐7)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- neuroinflammation, depression, schizophrenia, mood disorders, inflammatory cytokines, monoamine neurotransmission, neuroendocrine regulation, excitotoxicity, neuroplasticity, gut microbiota, diet, early life stress, inflammatory mediators
- MeSH terms
- Brain, Humans, Inflammation, Neuronal Plasticity, Neurosecretory Systems, Schizophrenia, Stress, Psychological, Cytokines, Mood Disorders
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