Family Support and C-Reactive Protein in Relation to Body Mass Index Among Schizophrenic Outpatients

Schizophrenia has been associated with increased inflammatory and metabolic disturbances. Perceived family support possibly effectuates changes in inflammatory and metabolic biomarkers. The aim of the present study was to determine the associations between family support, C-reactive protein (CRP) and Body Mass Index (BMI) in a sample of schizophrenic outpatients. In this cross-sectional correlation study 206 schizophrenic outpatients in clinical remission completed the standardized self-report questionnaire that assessed family support (family support scale-FSS). Sociodemographic, clinical and laboratory data were also recorded. 49.5% of the participants had detectable CRP values (≥0.11mg/dl), whereas 14.6% had positive CRP levels (>0.6mg/dl). There was a significant difference in CRP levels across the different BMI groups (normal-weight/ overweight vs. obese). For obese patients, the crude odds ratio (OR) for detectable CRP values was 1.980 with 95% confidence interval (CI) [1.056, 3.713] and for positive CRP values the OR was 27.818 (95% CI [6.300, 122.838]). Significant positive correlations were observed among CRP, BMI and illness duration, while scores on FSS were negatively associated with these variables. Results from the binary logistic regression analysis indicated that both BMI and family support were significant factors in determining the likelihood of having positive CRP levels, with each unit increase in the BMI associated with a 17% (95% CI [0.025, 0.337]) increase in the odds and with each unit increase in family support leading to a 8.6% (95% CI [0.018, 0.15]) decrease. The moderation analysis revealed that the association between family support and the probability of having positive CRP levels depends on BMI values, but the magnitude of the decreased risk for positive CRP associated with the protective effect of family support is significant (b=-0.1972, SE=0.053, OR=0.821, p=0.000, 95% CI [-0.3010, -0.0934]) only for obese patients. The effect of perceived family support on inflammatory responses becomes evident in cases where beyond metabolic complications inflammatory processes have already been established. However, primary interventions are considered necessary for schizophrenic patients in order to maintain BMI within normal limits and avoid the subsequent nosological sequelae.