%0 Journal Article
%T Psychotic mania in glucose-6-phosphate-dehydrogenase-deficient subjects
%A Alberto Bocchetta
%J Annals of General Psychiatry
%D 2003
%I BioMed Central
%R 10.1186/1475-2832-2-6
%X 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.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.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.Glucose-6-phosphate dehydrogenase (G6PD) is a cytosolic enzyme whose main function is to produce NADPH, a key electron donor in the defense against oxidizing agents and in reductive biosynthetic reactions [1]. More than 100 missense mutations in the human X-linked gene encoding G6PD are known to date. The main clinical consequence of these mutations is an enzyme deficiency associated with acute hemolytic anemia, triggered by fava beans, drugs, and some other sources of stress [2]. G6PD deficiency has become common in many populations as a result of malaria selection and it has been estimated that 200 million people around the world are G6PD deficient, including about 11% of Afro-Americans and 62% of Kurdish Jews. Rates in southern Sardinia range from 15 to 30% [3].In the early 1980s, we used G6PD deficiency as a traditional X-chromosome marker in a linkage study of manic-depressive illness [4]. Subsequent to this date, we started a systematic survey of G6PD activity in outpatients admitted to our Department, which is one of the reference centers for the management of lithium and related treatments in southern Sardinia. In an account regarding 662 consecutive outpatients
%U http://www.annals-general-psychiatry.com/content/2/1/6