[C-reactive protein and agitation in patients with schizophrenia: A cohort study with a control group]. / Protéine C-réactive et agitation chez des patients atteints de schizophrénie : suivi d'une cohorte avec groupe témoin.

BACKGROUND: Recent studies first reported the relevant role of the immune system in the pathophysiology of schizophrenia and then the association between inflammation and agitation. OBJECTIVES: In this study, we aim to explore the relationship between CRP (C-reactive protein) levels and agitation in patients with schizophrenia. METHODS: We conducted a cohort study with a comparison group of 60 patients with a DSM5 diagnosis of schizophrenia who were followed by the Department of Psychiatry of the University Hospital of Marrakech in Morocco. Patients were divided into two groups according to the state of agitation evaluated by the PANSS Excitement scale. These two groups have been matched according to age and gender. A comparison of CRP level, clinical and laboratory characteristics between the two groups and a monitoring of CRP level in the agitated group after 3 weeks of treatment were performed. RESULTS: Inpatients with agitation displayed a significantly high CRP (P<0.0001), a high score of PANSS total (P<0.0001), PANSS positive (P<0.0001) and general PANSS (P<0.0001). After treatment, there was a significant reduction in CRP (P<0.0001) and PANSS excitement (P<0.0001). CONCLUSION: These results confirm the role played by inflammation and immunity in agitation behavior in patients with schizophrenia and highlight the interest of the CRP assay at the time of admission of patients as a potential marker of agitation in hospitalized patients with schizophrenia.

[Risk factors related to homicide in Moroccan patients with schizophrenia]. / Facteurs de risque de passage à l'acte d'homicide chez des patients marocains atteints de schizophrénie.

BACKGROUND: Persons with schizophrenia are thought to be at increased risk of committing violent crime - 4 to 6 times the level of general population individuals without this disorder. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link. OBJECTIVES: The objectives of this study were to describe the characteristics of homicide in Moroccan patients suffering from schizophrenia and to determine the correlated sociodemographic, clinical and toxic variables. METHODS: The study included two groups of patients with a DSM IV diagnosis of schizophrenia who attended the "Ibn Nafis" university psychiatric hospital of Marrakech in Morocco. The first group was composed of 30 patients hospitalized for homicide in the forensic unit between 1 January 2005 and 31 August 2015. The second group included 90 patients without any criminal record. These two groups have been matched according to age and gender. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups. RESULTS: Data analysis has objectified the following results: the mean of age in the first group was 37.03 (±9.09) and in the second group was 31.4 (±8.76). No significant differences were found between the two groups regarding the different sociodemographic variables and the age of onset of disease. Significant differences were found between the two groups regarding: personal antecedents of attempt of homicide (P=0.003), personal antecedents of attempt of suicide (P<0.001), a history of previous violence (P=0.005), untreated psychosis before the act (P<0.001), poor medication compliance and a low familial support (P<0.001), antisocial behavior (P<0.001) and addictive behavior (P=0.005). DISCUSSION: Several studies identified some possible predictor factors for violent behavior: poor compliance, lack of insight impulsivity and paranoid-hallucinatory symptoms, systematized delusions and addictive behavior seem to considerably increase the risk of turning to violence. Demographic variables as suggested by other studies are less valuable predictors of homicide in patients with schizophrenia. CONCLUSION: Awareness of these factors will allow us to provide improved prevention of violence within schizophrenic subjects. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease and an improvement of medication compliance.