Mitsuda psychosis and holodysphrenia revisited: An atypical psychosis in a patient with parieto‐occipital paroxysmal electroencephalographic activity and high unconjugated bilirubin

Marques, João Gama

doi:10.1111/pcn.12487

Cited by 5 publications

(3 citation statements)

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“…Using regression models (ANCOVA), the authors found that gender had a significant effect on TB (β = 0. A more recent study by Gama-Marques et al 10 set out to evaluate whether high, yet within normal range, UCB levels could be considered a potential biomarker in the differentiation among acute psychotic patients 64 with schizophrenia, schizoaffective disorder, and bipolar disease. Two hundred four acute patients (50 with schizophrenia, 69 with schizoaffective disorder, and 85 with BD) and 55 healthy controls were included.…”

Section: High Levels Of Ucb In Humans With Schizophreniamentioning

confidence: 99%

Unconjugated bilirubin and schizophrenia: a systematic review

2019

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Schizophrenia is a complex syndrome of unknown etiology and difficult to manage. Unconjugated bilirubin has been researched as a potential biological marker of this syndrome. The objective of this review article was to gather the studies published to date on the relationship between this molecule and schizophrenia. Broad inclusion criteria have been used (PRISMA) to include as many relevant studies as possible. Fourteen studies were selected: 3 analyzed the effects of unconjugated hyperbilirubinemia in animal models; 6 demonstrated an increased incidence of schizophrenia in patients with increased unconjugated bilirubin; 2 reported an increased incidence of the disease in patients with decreased unconjugated bilirubin; and 3 linked an increased incidence of schizophrenia with an increased excretion of the oxidative product of bilirubin, the so-called biopyrrins. Because of apparently contradictory reported results, the hypothesis that the relationship between schizophrenia and unconjugated bilirubin was not linear and that there was an inflammatory dysfunction explaining this was considered. The 2 most accepted models for the pathophysiology of schizophrenia are described, and the possible role of the molecule in each is clarified. The bilirubin buffer system and its role in antioxidant defense was explored. The average levels of unconjugated bilirubin in patients with schizophrenia, schizoaffective disorder, and bipolar disorder were also compared, having been hypothesized that these diseases could be different points of a same pathological spectrum. Finally, it was concluded that unconjugated bilirubin is a promising molecule that could be used as a possible biological marker for schizophrenia, and the necessity of subsequent efforts for its research was considered.

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Section: High Levels Of Ucb In Humans With Schizophreniamentioning

confidence: 99%

Unconjugated bilirubin and schizophrenia: a systematic review

2019

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“…In the other hand, patients suffering from schizophrenia frequently presented with higher than expected plasma UCB concentration, especially when acutely ill and admitted to the hospital [ 15 ]. Some authors suggested that the association of hyperbilirubinemia and schizophrenia disorders is stronger in acute psychosis episodes [ 16 , 17 ]. Indeed, patients with schizophrenia with higher rates of hyperbilirubinemia presented a positive correlation between bilirubin levels and psychosis severity, namely higher scores on the positive and negative symptoms (PANSS) [ 18 – 20 ].…”

Section: Unconjugated Bilirubin: a Biomarker Candidate For Acute Psycmentioning

confidence: 99%

“…After publishing a case report [ 17 ] we got interest in this topic, so we did a retrospective study and found a 0.1 mg\dL significant statistical difference ( p ≤ 0.0001) between the UCB mean values of patients with schizophrenia (0.39 mg\dL with SD 0.16 mg\dL) patients vs. bipolar patients (0.29 mg\dL with SD 0.13 mg\dL) [ 14 ]. Using www.openepi.com software, with a confidence interval of 95%, and a beta value of 80%, we calculate a minimum sample size of 34 patients per group.…”

Section: Unconjugated Bilirubin: a Study Protocol For The Psychosis Smentioning

confidence: 99%

A Perspective on a Possible Relation Between the Psychopathology of the Schizophrenia/Schizoaffective Spectrum and Unconjugated Bilirubin: A Longitudinal Protocol Study

Marques

Arantes-Gonçalves²

2018

Front. Psychiatry

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Some authors suggest a relation between Unconjugated Bilirubin (UCB) plasma high levels and schizophrenia, as schizophrenia patients have been showing higher UCB levels when compared with other psychiatric patients and general population. These higher UCB levels have been already correlated with acute psychotic states, positive symptoms, and poor outcome in patients with schizophrenia. Schizophrenia and schizoaffective disorders share common symptoms but there aren't yet accepted biomarkers for their distinction. In our study protocol we propose an observational longitudinal study on a sample composed of two subgroups: patients with schizophrenia and patients with schizoaffective disorder. We will compare the UCB levels between groups, and search for a possible correlation with patient's psychopathology. For that purpose we will use nosological, psychopathological, neuropsychological, and psychosocial instruments. Thus we will be testing two different hypotheses: (1) Is UCB serum level a diagnosis indicator, with categorical distinction potential, between groups of patients with different psychotic disorders? (2) Is UCB serum level a severity indicator, with dimensional distinction potential, among groups of patients with the same psychotic disorder? We believe that UCB mean levels may contribute to some clarification of this controversy, as a potential biological indicator, facilitating the distinction between these two diagnostic categories and\or discriminating the dimensional severity among each of these psychotic conditions. Thus we may be opening a new opportunities for innovative and exciting biological psychiatry research regarding organic aspects in the schizophrenia spectrum.

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