The aim of this study was to look into the balance of pro-inflammatory (TNF-α, IL-6) and anti-inflammatory (TGF-β) cytokines and their association with stress, alterations in HPA axis activity and the disease severity in acute psychosis.Socio-demographic and clinical details were collected from 41 in-patients with a diagnosis of Acute and Transient Psychotic Disorder. Holmes and Rahe Stress Scale for stress in the preceding year, and Brief Psychiatric Rating Scale at baseline and follow up (4–12 weeks) for psychopathology were applied. IL-6, TNF-α (pro-inflammatory), TGF-β (anti-inflammatory) and Cortisol (morning and afternoon values) were measured at baseline and follow up.A total of 30 out of 41 cases recruited had follow up data available. The levels of IL-6 (p < 0.001), TNF-α (p < 0.001) and TGF-β (p < 0.001) at baseline were all found to be significantly elevated compared to 42 age and gender matched healthy controls. There was a significant increase in the levels of TNF-α (p = 0.020) and morning levels of cortisol (p = 0.009) and a significant decrease in the levels of TGF-β (p = 0.004) and afternoon levels of cortisol (p = 0.043) from baseline to follow up.This study showed that there was an increased level of both pro and anti-inflammatory cytokines at baseline and a prolonged pro − inflammatory compared to anti − inflammatory response which warrants larger prospective studies and comparative studies to patients with schizophrenia and bipolar disorders.
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Young et al. (2008) studied this question.