Résumé
Schizophrenia (SZ) is characterized by a variable clinical expression and course peppered/hampered by severe complications. In particular, resistance to treatment (overall-TRS, treatment resistant SZ including UTRS, ultra-TRS) and metabolic syndrome (MetS) are highly prevalent, and both demonstrated to be underpinned, at least partly, by pro-inflammatory processes. Given that such processes also underlie SZ per se , we hypothesized that potential inter-twinning between SZ-and MetS-related inflammatory processes may exert a combined effect on the risk of having overall-TRS/UTRS. A total of 419 outpatients with SZ underwent clinical assessments and blood sample collection. Using the values of circulating levels of eleven cytokines, we built a ratio between pro-and anti-inflammatory components respectively corresponding to the immunoinflammatory response system (IRS) and the compensatory immunoregulatory reflex system (CIRS) which overall reflect the underlying in-flammatory status. Such ratios allowed to categorize the patients according to Inflammation and MetS on four categories as follow: symbolscript symbolscript symbolscript and Inflam-mation(-)MetS(-). Multivariate logistic regression analysis showed that the combination of inflammation and MetS modulate the risk of having the overall-TRS symbolscript symbolscript 95 %CI [1.04-5.00], p symbolscript 0.039 and symbolscript symbolscript 95 % CI [1.76-11.97], p symbolscript 0.002 overall in comparison to Inflammation(-)MetS(-)]. Moreover, we observed that individuals with UTRS are those associated with both inflammation and/or MetS. Our results demonstrated the potential combined effect of MetS and inflammation towards resistance to treatment. Given that overall-TRS/UTRS are unpredictable while both inflammation and MetS can be early detected and managed, our findings shed new light on the possibility to better prevent treatment resistance in SZ.