Metabolic and Inflammatory Causes of Psychosis V2
Research type
Research Study
Full title
The occurrence of metabolic and inflammatory causes of psychosis in admissions to a psychiatric unit
IRAS ID
152252
Contact name
Georgeta Fanea
Contact email
Sponsor organisation
The University of Manchester
Research summary
Standard psychiatric practice regarding investigation of the underlying cause of psychotic illnesses is very limited. In the majority of psychotic illnesses a cause is neither sought nor identified and patients are simply given antipsychotic medication. This approach has persevered despite the accumulation of reports in the medical literature describing autoimmune diseases and inherited metabolic disorders that can present in adulthood as psychoses. With the emergence of specific treatments for these diseases, there is the possibility that in a proportion of patients with psychosis the course of their condition can be changed beneficially.
The following inherited metabolic disorders: Niemann-Pick Disease type C, Homocystinuria due to cystathionine-ß-synthase deficiency, methylenetetrahydrofolate-reductase deficiency or cobalamin metabolism defect Cb1C, X-linked Adrenoleukodystrophy, Wilson’s Disease, Metachromatic Leukodystrophy, a-Mannosidosis, Fabry Disease, Gaucher Disease and GM2-Gangliosidosis and several autoimmune diseases like Systemic Lupus Erythematosis, Hashimoto’s Encephalitis, as well as Encephalitis due to anti-NMDAR, anti-GAD and anti-VGKC antibodies may present in adulthood as psychoses and can be diagnosed through blood tests.
The primary objective of this study is to establish if the current standard management of patients with psychosis needs to be changed based on the prevalence of organic causes of psychosis. The secondary research objective is to determine if the oxysterol test utilised in detecting Niemann-Pick Disease type C is altered by the use of antipsychotic medication. We aim to recruit 180 patients with psychosis admitted to Meadowbrook Psychiatric Unit and carry out blood tests for the aforementioned diseases. For the oxysterol assay we aim to recruit 100 patients receiving and 100 patients not receiving antipsychotics. Blood tests will be performed in various specialised laboratories and the results will be statistically analysed and then disseminated in an anonymised manner.This study will ultimately increase the clinicians’ awareness of the importance of screening for organic causes of psychosis.
REC name
Wales REC 6
REC reference
14/WA/1031
Date of REC Opinion
27 Jun 2014
REC opinion
Further Information Favourable Opinion