Abstract

Objectives: The aim of this study was to evaluate bilirubin level changes in patients with schizophrenia and other psychotic disorders. Method: This was a comparative cross-sectional study. Hospitalized patients of at least 20 years of age, with the primary diagnosis of psychosis, were first evaluated using Structured Clinical Interview DSM-IV for Axis I disorders (SCID-I) and 162 patients with schizophrenia and 155 patients with bipolar mood disorders entered the study. Ninety five cardiac patients who were admitted to CCU with no personal and family history of psychosis were selected as the control group. Plasma levels of total and direct bilirubin, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and prothrombin time (PT) as well as the reticulocyte count were measured for all of the subjects. Also, bilirubin levels at admission and at discharge were compared. Results: Distribution of age, sex and also positive and general psychopathology subscales were not significantly different in the relevant groups. Initial total bilirubin levels were higher in patients with schizophrenia (p<0.001) and  were more associated with general psychopathology subscale rather than positive subscale. Bilirubin level was decreased in all three groups at discharge (p<0.05) and the rate of decrease was higher in schizophrenic group (p<0.001). Conclusion: Mild increase in serum bilirubin level is an usual finding in acute psychosis and does not require further clinical or laboratory investigation, but the difference observed between the admission and discharge bilirubin levels is higher in patients with symtoms of psychosis especially in schizophrenics (more than that expected to be caused merely by imposed stress of acute mental illness or hospitalization).