Elevated Bilirubin in Acute and Transient Psychotic Disorder

Introduction: Mild unconjugated hyperbilirubinemia seems to be more common in patients with disorders from the schizophrenic spectrum than in other psychiatric patients or in the general population and has been linked to brain alterations. This spectrum however contains a number of diagnostic entities that might not share the same etiological and environmental factors. Methods: 325 hospital admissions were analysed over a one-year period. Results: We found an association of acute and transient psychotic disorders (ATPD) with total bilirubin level and rate of elevated total bilirubin that was increased compared to paranoid schizophrenia and schizoaffective disorder, all patients, and was higher than in the general population. Concomitant increased direct bilirubin might suggest that reduced UGT activity, causing Gilbert's syndrome in the general population, is not the reason for elevated bilirubin in ATPD. Conclusions: The difference between ATPD and schizophrenia/schizoaffective disorder might be due to disorder severity, aetiology, or environmental factors that influence enzyme activity.