Global Journal of Medical Research, A: Neurology & Nervous System, Volume 23 Issue 3

The Link between Social Anxiety and Peripheral Inflammatory Markers in Patients with Schizophrenia Diagnoses Amelia Dias Teixeira α , Victor Hugo Schaly Cordova σ & Paulo Belmonte-de-Abreu ρ Abstract- Background: It exist increasing studies on the inflammatory process in psychiatric disorders, in which inflammation in schizophrenia (SZ) isquestioned. Objective: assess the association between social anxiety (SA) and inflammation in patients with SZ, measuring primarily the neutrophil-to-lymphocyte ratio (NLR) and secondarily the systemic immune-inflammation index (SII), monocyte-to- lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR). Methods: A cross-sectional study. Results: Of the 82 patients who met the inclusion criteria, 59 patients had SA and observed a significant alteration in inflammation markers in patients with SZ, especially NLR. Conclusion: NLR was significantly higher when compared to the cut-off point in the general sample. The greater the severity of SZ symptoms, the higher the SA in these patients and patients with SA showed higher scores on Brief Psychiatric Rating Scale(BPRS)and Generalized Anxiety Disorder Scale(GAD-7), and the higher the SA scores, the higher the NLR, SII, and PLR. Our findings indicate that inflammation appears to be a characteristic of patients diagnosed with SZ, agreeing with the conclusions of the literature and that SA may cause an additional increase in inflammatory indices in these patients. In addition, inflammation was seen to interfere with SA, independent of the other variables. Keywords: social anxiety, schizophrenia, peripheral markers of inflammation, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index. I. I ntroduction chizophrenia (SZ) is a serious and complex mental disorder that affects around 1% of the world's population, causing damage to the patient and family, of multifactorial origin [1].Its diagnosis involves a set of signs and symptoms and impaired professional or social functioning [2]. Its symptoms affect perception, thought, affect, and behavior [3] without any pathognomonic symptoms [2] and involve distortions of Author α σ ρ : Graduate Program in Psychiatry and Behavioral Sciences, Schoolof Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Author ρ : Department of Psychiatry and Forensic Medicine, Schoolof Medicine. Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Corresponding Author α : Amelia Dias Teixeira, Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Campus Saúde. Rua Ramiro Barcelos, 2400, 2º andar. 90035003 - Porto Alegre, RS – Brasil. e-mail: amelia_psico@hotmail.com perception about oneself and with external reality [1]. Two or more of the following symptoms are required for diagnosis: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms such as diminished emotional expression or avolition, with at least one of the symptoms being the first three [3]. Social anxiety (SA) or social phobia is not included among the necessary symptoms, but is frequent before the onset of the disorder [1] and can represent both a residual and a complication of the illness, contributing to great personal suffering and functional impairment after the acute phase of SZ. SA can be defined by intense or heightened fear or anxiety of one or more social events in which the person is exposed to the likely evaluation of other individuals [2], as a result of negative assessment [2,4], the possibility of judgment or rejection [4]. It is an interpersonal, intrapersonal, and social system disorder, with impaired reciprocal interaction and communication, such as failure of social cohesion and rejection, emotional and physical feelings such as nervousness and sweating, avoidance attitude of feared situations, and dysfunctional beliefs in social situations or imagining these events [5]. Fear, anxiety or avoidance in people with SA, or social phobia imply clinically significant distress or impairment in social, occupational, or other essential spheres of functioning [2]. Several peripheral markers derived from blood count have been increasingly used as an indirect measure of inflammatory activity in the brain in psychiatric disorders [6-10], calculated under simple laboratory exams [10], from a complete blood count [6,11-13]. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR)and platelet-to- lymphocyte ratio (PLR) have been investigated as clinical circulating markers of chronic inflammation in many diseases [9,10,14-17], especially NLR [7,8,18]which constitutes baselines of the innate (neutrophil) and adaptive (lymphocyte) immune systems [6,19,20]and may be less affected by confounding variables, being an effective biomarker to identify patients who may benefit from pharmacological S 35 Year 2023 Global Journal of Medical Research Volume XXIII Issue III Version I ( D ) A © 2023 Global Journals