Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Michael Eriksen Benros, University of Copenhagen, Denmark
- Second opponent: Professor Janet Cunningham, Uppsala University, Sweden
- Third member and chair of the evaluation committee: Associate Professor Linda Elise Couëssurel Wüsthoff, University of Oslo
Chair of the Defence
Professor Lars Mehlum, University of Oslo
Principal Supervisor
Professor II Nils Eiel Steen, University of Oslo
Summary
Schizophrenia and bipolar spectrum disorders are severe mental disorders with overlapping clinical features, a high burden of somatic comorbidity, and reduced life expectancy. Immune dysregulation has been proposed as a contributing mechanism, as reflected by a range of alterations in peripheral immune markers. However, the role of the immune system in illness course, treatment response and biological aging remains unclear.
This thesis examined associations between blood-based immune markers and diagnosis, illness course characteristics, use of psychotropic agents and biological aging. Participants were drawn from the ongoing Thematically Organized Psychosis (TOP) study, including individuals with schizophrenia, bipolar spectrum disorders and healthy controls. Across the three observational cross-sectional studies, we applied principal component analysis, analyses of covariance, and linear regression models, all adjusted for relevant confounders.
Findings suggest cell adhesion molecule-mediated blood-brain barrier (BBB) dysfunction across the diagnostic groups. In schizophrenia, pro-inflammatory and neuroprotective markers were linked to illness course severity. Associations between immune markers and psychotropic medication use were generally modest, but may suggest minor immunomodulatory effects of antipsychotics, antidepressants and mood stabilizers. Moreover, we found limited evidence supporting immune dysregulation and inflammation as a key mechanism in accelerated aging, as measured by telomere length.
These findings suggest that low-grade inflammation and BBB-related changes may represent shared biological features across schizophrenia and bipolar spectrum disorders, while the impact of immune dysregulation on accelerated aging is questioned. Systemic immune aberrations appear to be only modestly related to psychotropic agent use.
Additional information
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