DOI: 10.38053/acmj.1988609 ISSN: 2718-0115

Serum CRP, vitamin D, and ferritin levels in male inpatients with schizophrenia spectrum disorders and bipolar mania: a retrospective analysis of clinical correlates

Hatice Ayça Kaloğlu, İlke İşler, Yasir Şafak
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Aims: Schizophrenia spectrum disorders and bipolar mania share neurobiological mechanisms, yet conventional diagnostic categories often fail to explain clinical heterogeneity. This study investigated whether peripheral biomarkers-C-reactive protein (CRP), 25-hydroxyvitamin D [25(OH)D], and ferritin-could identify biologically meaningful subgroups and predict short-term treatment outcomes within a precision psychiatry framework.Methods: A retrospective review of 139 males inpatients (101 with schizophrenia spectrum, 38 with bipolar mania) was conducted. Serum CRP, 25(OH)D, and ferritin levels were measured within 24 hours of admission. Clinical outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Young Mania Rating Scale (YMRS). Hierarchical regression analyses, adjusted for variables such as age, smoking, and clozapine use, examined the associations between baseline biomarkers and clinical trajectory.Results: No significant differences in biomarker levels were found between diagnostic groups. However, within the schizophrenia group, lower 25(OH)D levels were associated with greater admission severity and remained independently associated with higher discharge PANSS negative symptom scores. In the bipolar mania group, higher baseline CRP independently predicted a lower percentage of improvement in YMRS scores during hospitalization. Ferritin and CRP correlations with admission severity did not survive adjusted analyses.Conclusion: While peripheral biomarkers did not distinguish between the two diagnoses, they served as significant prognostic indicators. Specifically, vitamin D levels related to negative symptom burden in schizophrenia, while CRP predicted poorer short-term improvement in bipolar mania. These findings suggest that peripheral biomarkers are more valuable as adjunctive measures for predicting clinical course rather than as standalone diagnostic tools.

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