Structural brain changes in schizophrenia associated with idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome): a planimetric CT study

Elevated Bilirubin in Acute and Transient Psychotic Disorder

“…Therefore, patients with acute remitting psychosis might present at hospital in a more severe state, and the association of elevated bilirubin with ATPD could refl ect an association with severity of the disorder. It has been proposed that patients with schizophrenic disorder with and without hyperbilirubinemia diff er in brain structure [10,11,13] .…”

“…These studies indicate an incidence of elevated total and unconjugated bilirubin of 20 -25 % in patients with disorders from the schizophrenic spectrum compared to 10 % of all psychiatric patients. The latter study group has also provided evidence that patients with schizophrenia and hyperbilirubinemia show structural alterations in brain tissue, compared to patients with schizophrenia but without hyperbilirubinemia [10,11,13] . Both study groups have suggested that these increased bilirubin levels are due to Gilbert ' s syndrome (GS).…”

Schizophrenia and Idiopathic Unconjugated Hyperbilirubinemia (Gilberts Syndrome)

“…We also have observed that patients suffering from schizophrenia frequently have an increased bilirubin plasma concentration when admitted to the hospital [7,8]. Moreover, schizophrenic patients with GS showed significant enlargement of almost all CSF spaces by brain CT study [9], compared to both schizophrenics without GS and normal controls. Those findings suggest that there are …”

“…These reports suggest that bilirubin has some effect on brain development or is neurotoxic and may play a role in brain tissue changes in seen on CT and clinical features in schizophrenia with GS. Previously, we reported that schizophrenic patients with GS showed diffuse enlargement of almost all CSF spaces by brain CT study [9]. Therefore, it may be considered to represent the most severe schizophrenic subtype in both acute clinical symptomatology and underlying brain pathology.…”

Gilbert's syndrome in a patient with predominantly negative symptoms of schizophrenia

“…Several research studies have examined physical and metabolic differences in the brains of schizophrenic patients with Gilbert's syndrome, showing increased signal intensities in the frontotemporal cortex, limbic system and basal ganglia on FLAIR MRI [9], enlargement of CSF spaces [10], and altered metabolite ratios [11]. It is not clear if these are causative of schizophrenia or merely represent an effect of Gilbert's syndrome or other underlying pathological processes.…”