# Association Between Caffeine Levels and Symptom Profile in Schizophrenia: Results from a Cohort Study in Central Greece

## TL;DR

Higher caffeine levels in schizophrenia patients are linked to worse attention and more violent behavior, suggesting caffeine monitoring could help manage symptoms.

## Contribution

This study is the first to show a correlation between caffeine serum levels and symptom profiles in schizophrenia patients.

## Key findings

- Elevated caffeine levels correlate with impaired attention in schizophrenia patients.
- Higher caffeine levels are associated with increased violent behavior in these patients.

## Abstract

What are the main findings?
Elevated caffeine serum levels are correlated with impaired attention.Violent behavior is seen more commonly as caffeine serum levels increase.

Elevated caffeine serum levels are correlated with impaired attention.

Violent behavior is seen more commonly as caffeine serum levels increase.

What are the implications of the main findings?
Caffeine may have a paradoxical effect on attention in patients with schizophrenia.The introduction of routine caffeine monitoring may help manage patients prone to aggressive behavior.

Caffeine may have a paradoxical effect on attention in patients with schizophrenia.

The introduction of routine caffeine monitoring may help manage patients prone to aggressive behavior.

Introduction: Caffeine is the most consumed psychostimulant worldwide. Schizophrenia is an uncommon mental disorder affecting 0.34% of the global population. The aim of the current study was to investigate a possible association between caffeine consumption and symptom profile, dangerous behavior, and cognitive functions in patients with schizophrenia. Methods: This prospective cohort study included consecutive patients diagnosed with schizophrenia who were admitted to the psychiatry ward or visited the psychiatry outpatient clinics at a tertiary University Hospital in Greece for a period of 12 months. All patients underwent an extensive psychiatric and cognitive function assessment using the standardized Greek version of the Positive and Negative Symptom Scale (PANSS), the generalized anxiety disorder scale (GAD-7), and the Addenbrooke cognitive test (ACE-R). Results: In total, 53 patients were included in the present study. Mean age of the participants was 45 ± 11 years. The mean age at onset was 23 ± 7 years, while mean duration of illness from age of onset was 21.58 years. Caffeine serum levels exhibited a positive correlation with the poor attention component of the general psychopathology PANSS subscale, as well as with the attention and orientation component in the ACE-R. Moreover, another positive correlation was observed between the perilous behavior PANSS subscale and caffeine serum levels. Conversely as caffeine serum levels increased, fewer negative symptoms were reported, specifically, the poor rapport and passive/apathetic social withdrawal of the negative PANSS subscale. Conclusions: In summary, this study highlights the significant associations between caffeine serum levels, symptom severity, and cognition among patients with schizophrenia. While the findings provide valuable insights, they should be interpreted with caution due to the study’s several limitations. More larger scale cohort studies are needed in order to elucidate the impact of caffeine consumption in patients with schizophrenia.