Objective:

To identify risk factors for splenomegaly in chronic schizophrenia patients and clarify associations among metabolic−immunoinflammatory pathways, psychiatric symptoms, and splenomegaly, ultimately aiming to optimize somatic monitoring and intervention strategies.

Key Findings:

• Higher levels of lipoprotein(a), cholesterol, triglycerides, HbA1c, CRP, IL-6, and β2-microglobulin in the splenomegaly group (p < 0.05), indicating significant metabolic dysregulation.
• Increased incidence of fatty liver and higher PANSS negative symptom scores in the splenomegaly group, suggesting a link between metabolic and psychiatric health.
• Lower usage rate of aripiprazole in the splenomegaly group, which may influence treatment outcomes.
• HbA1c (OR = 1.797, p = 0.046) and PANSS negative symptom score (OR = 2.258, p = 0.003) independently associated with splenomegaly, highlighting the need for targeted monitoring.
• Aripiprazole use associated with lower odds of splenomegaly (OR = 0.656, p = 0.041), suggesting potential therapeutic benefits.

Interpretation:

Splenomegaly in chronic schizophrenia patients is linked to metabolic abnormalities and immunoinflammatory activation, with negative symptoms serving as an early warning signal for potential health deterioration.

Limitations:

• The study's case-control design may limit causal inferences, and further longitudinal studies are needed.
• Potential confounding factors, such as lifestyle and comorbidities, were not fully accounted for in the analysis, which may affect the results.

Conclusion:

Monitoring splenomegaly in chronic schizophrenia patients is crucial due to its association with metabolic and inflammatory pathways, and aripiprazole may mitigate these risks, ultimately improving patient outcomes.