Schizophrenia-Like Psychosis Caused by a Metabolic Disorder

Pepplinkhuizen, L.; Blom, W.; Bruinvels, J.; Moleman, P.

doi:10.1016/s0140-6736(80)91000-4

Cited by 48 publications

(18 citation statements)

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“…The paucity of positive results may be related to either the heterogeneity of the patients included in the studies or to the presence of transient disturbances in neurochemical processes during the symptomatic period. The latter was demonstrated in a subgroup of patients with CP who showed a disturbed metabolism of the amino acids serine and glycine [17, 18]. The clinical picture of this acute and transient psychosis is dominated by psychedelic experiences, dysperceptions, derealization, and depersonalization and was preliminary called APP+ [17, 19].…”

Section: Introductionmentioning

confidence: 99%

“…The latter was demonstrated in a subgroup of patients with CP who showed a disturbed metabolism of the amino acids serine and glycine [17, 18]. The clinical picture of this acute and transient psychosis is dominated by psychedelic experiences, dysperceptions, derealization, and depersonalization and was preliminary called APP+ [17, 19]. Its symptom profile, however, is also present in the confusion and anxiety-happiness psychoses, as described by Leonhard [3], but not fully included in the ICD-10 criteria for APP.…”

Section: Introductionmentioning

confidence: 99%

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Nonschizophrenic Psychotic Disorders: The Case of Cycloid Psychoses

et al. 2004

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Background: Cycloid psychosis is a psychiatric disorder known for about 100 years. This disorder is at present partly and simplified represented in the ICD-10. Sampling and Methods: Over a period of 15 months, 139 consecutively acutely admitted psychotic patients were assessed, by means of different diagnostic instruments, in order to investigate the prevalence and the symptom profile of cycloid psychoses. In addition, the concordance between the diagnoses cycloid psychosis, brief psychotic disorder, and acute polymorphic psychotic disorder with or without symptoms of schizophrenia was calculated. Results: Cycloid psychoses were present in 13% of the patients. There was a significant but small overlap with the DSM brief psychotic disorder and the ICD acute polymorphic psychotic disorder. Conclusions: This study demonstrates that cycloid psychoses can be identified with the proper diagnostic instruments in a proportion that is also found in other studies. Since this type of psychosis entails a distinct prognosis and may require a specific treatment, its identification is of clinical importance. Limitations are the nature of the psychiatric facility with an inherent bias in the selection of patients and the lack of a long-term evaluation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nonschizophrenic Psychotic Disorders: The Case of Cycloid Psychoses

et al. 2004

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“…When, after recovery, a single dose of serine (2 mmollkg) was administered orally to these patients (see Table I), the characteristic symptoms -especially the sensory perceptual distortions -were evoked two to four hours after ingestion of this amino acid. Oral administration of serine was without effect in another group of patients who had also suffered from acute psychotic episodes but without disturbances of sensory perceptions Bruinvels et al, 1980;Bruinvels and Pepplinkhuizen, 1985;Wunderink et al, 1986). These experiments suggest that the group of episodic psychotic patients with disturbances of sensory perceptions may indeed represent aseparate entity of psychotie iIIness.…”

Section: Entgleisung Des Cl-stoffwechsels Bel Episodischen Schlzoaffementioning

confidence: 99%

“…The c1inical features of these patients, whose acute psychotic episodes so c1early resemble a "model" psychosis known to occur after the intake of drugs like LSD, led the authors to assume that an endogenous synthesis of hallucinogenic substances may be responsible for the psychedelic phenomena reported by these patients. It was postulated that a disturbance in the serine-glycine metabolism, the ultimate source of Onecarbon metabolism in the human body, is probably the cause for the generation of psychotic symptoms (Pepplinkhuizen eta\., 1980;Bruinvels et al, 1980). An increased conversion of serine into glycine will give an excessive formation of one-carbon moieties which may subsequently result in an abnormal methylation or cyclization of monoamines of which several are known to be potent psychotogenic substances (Brimblecombe and Pinder, 1975).…”

Section: Entgleisung Des Cl-stoffwechsels Bel Episodischen Schlzoaffementioning

confidence: 99%

Derangement of One-carbon Metabolism in Episodic Schizoaffective Psychoses

Bruinvels¹,

Pepplinkhuizen²,

Fekkes³

1988

Pharmacopsychiatry

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The so-called cycloid or degeneration psychoses form a subgroup of the vaguely defined schizoaffective psychotic disorders, or according to the DSM III criteria: "Psychotic Disorders Not Elswhere Classified" (295.40; 298.80; 295.70; 298.90). Recovery from these acute psychoses is always complete, though episodic recurrence is commonly observed. The clinical syndrome is characterized by a kaleidoscopic, polymorphous clinical picture, e.g. sudden mood swings, motility disturbances, states of pananxiety and ecstasy with visionary experiences, perfunctory delusional ideas and visual hallucinations. At the onset of the psychoses many patients experienced psychedelic phenomena. It was postulated that these patients suffered from an abnormality in one-carbon metabolism resulting in the formation of beta-carbolines which were held responsible for evoking the psychotic symptoms. Since serine is the principle donor for one-carbon units, serine was administered to nonsymptomatic patients. Two to three hours after the administration patients became psychotic again. Analysis of blood samples from these patients showed a decreased fasting plasma concentration of serine and an increased fasting plasma level of taurine. In addition a decreased formation of serine from glycine was found. These findings are in agreement with the postulated derangement of one-carbon metabolism. Moreover, the beta-carboline norharman was present in blood obtained during acute psychotic episodes and was not present in blood of nonsymptomatic patients nor in blood of healthy controls. No abnormal activities of enzymes were found in skin fibroblasts from these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…In rare cases of cycloid psychosis, disturbances in amino acid metabolism were observed 30,31 . Hereditary factors have been demonstrated to play a minor role 32,33 , whereas environmental factors like maternal firsttrimester gestational infection and obstetrical complications, seem to be of etiological importance 34,35 .…”

Section: Introductionmentioning

confidence: 99%

Cycloid psychoses: Leonhard´s descriptions revisited

et al. 2012

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-Background and Objectives: Cycloid psychoses are characterized by polymorphic symptomatology with intraphasic bipolarity, a remitting and recurrent course and favourable prognosis. Perris and Brockington (P&B) described the first set of operational criteria that were partly incorporated in ICD-10. The present study investigates psychopathological profiles according to the P&B criteria and the original descriptions by Leonhard, both against the background of the criteria from the prevailing international classification systems.Methods: Eighty patients with psychotic disorders were recruited and assessed with various psychometric instruments at baseline and after six weeks of antipsychotic treatment in order to investigate the presence of cycloid psychoses according to Leonhard (LCP) and the effect of treatment with antipsychotics. The overlap between LCP and DSM-IV Brief Psychotic Disorder (BPD), ICD Acute Polymorphic Psychotic Disorder (APP) and P&B criteria was calculated.

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Schizophrenia-Like Psychosis Caused by a Metabolic Disorder

Cited by 48 publications

References 5 publications

Nonschizophrenic Psychotic Disorders: The Case of Cycloid Psychoses

Nonschizophrenic Psychotic Disorders: The Case of Cycloid Psychoses

Derangement of One-carbon Metabolism in Episodic Schizoaffective Psychoses

Cycloid psychoses: Leonhard´s descriptions revisited

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