Bocchetta Alberto
Bernard B, Brodie Department of Neurosciences, University of Cagliari, Italy.
Ann Gen Hosp Psychiatry. 2003 Jun 13;2(1):6. doi: 10.1186/1475-2832-2-6.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency has been associated with acute psychosis, catatonic schizophrenia, and bipolar disorders by previous inconclusive reports. A particularly disproportionate rate of enzyme deficiency was found in manic schizoaffective patients from 662 lithium patients surveyed in Sardinia. The purpose of this study was to describe clinical characteristics which may be potentially associated with G6PD deficiency. METHODS: Characteristics of episodes, course of illness, family pattern of illness, laboratory tests, and treatment response of 29 G6PD-deficient subjects with a Research Diagnostic Criteria diagnosis of manic schizoaffective disorder were abstracted from available records. RESULTS: The most peculiar pattern was that of acute recurrent psychotic manic episodes, mostly characterized by loosening of associations, agitation, catatonic symptoms, and/or transient confusion, concurrent hyperbilirubinemia, positive psychiatric family history, and partial response to long-term lithium treatment. CONCLUSIONS: A relationship between psychiatric disorder and G6PD deficiency is to be searched in the bipolar spectrum, particularly among patients with a history of acute episodes with psychotic and/or catatonic symptoms or with transient confusion.
既往一些尚无定论的报告表明，葡萄糖-6-磷酸脱氢酶（G6PD）缺乏与急性精神病、紧张型精神分裂症及双相情感障碍有关。在对撒丁岛662例锂盐治疗患者的调查中发现，躁狂型分裂情感障碍患者中酶缺乏的比例尤其失衡。本研究旨在描述可能与G6PD缺乏潜在相关的临床特征。方法：从现有记录中提取29例符合研究诊断标准的G6PD缺乏且诊断为躁狂型分裂情感障碍患者的发作特征、病程、家族疾病模式、实验室检查及治疗反应。结果：最特殊的模式是急性复发性精神病性躁狂发作，主要表现为联想松弛、激越、紧张症状及/或短暂意识模糊，同时伴有高胆红素血症、精神病家族史阳性，以及对长期锂盐治疗部分有效。结论：在双相情感障碍谱系中，尤其是有急性发作伴精神病性和/或紧张症状或短暂意识模糊病史的患者中，应探寻精神障碍与G6PD缺乏之间的关系。
