Folate and Homocysteine Levels in Patients with a First Psychotic Episode
Introduction: Homocysteine is a sulfur containing amino acid that has been widely investigated for its putative role in cardiovascular and neuropsychiatric disorders. Genetic and clinical data suggest that folate and homocysteine may play a role in the pathogenesis of psychiatric disorders. The total plasma homocysteine level is a sensitive measure of a functional folate deficiency. Several studies found a marked elevation of plasma homocysteine in schizophrenic patients. The study goal is to determine if this finding is already present in newly admitted patients. Material and Methods: Plasma folate (method CMIA, MEIA), vitamin B12 (method MEIA), and homocysteine (method FPIA), levels were determined in 59 consecutively admitted patients with a first psychotic episode and in 11 subjects considered at high risk (first degree relatives). Epidemiological and statistical data were calculated. Statistical evaluation was performed with EpiInfo 3.3.2. Student's t-test was used to compare continuous variables between groups. All statistical analysis were performed as two-sided tests. Statistical significance used 95% confidence interval was considered, if p < 0.05. Results: The data from our sample of patients revealed that more than two thirds of them presented low serum folate values and one third of patients had increased values of serum homocysteine. Vitamin B12 serum values lower than normal have been noted only in 8.47% patients and the stratified analyze by gender showed that the low values have been noted only in female gender. The difference between the mean value of the serum folate in the study group and that in the control group proved to be statistically significant (p=0.008) The difference between the mean serum values of homocysteine in these two patient groups was statistically significant only when comparing the female subgroups (p= 0.03). Discussions and Conclusions: Our findings revealed concordant aspects with data from the literature, which notes a high deficiency of folate in psychiatric population, especially in those with depression. Homocysteine levels were increased in a large proportion of these newly admitted patients. These high homocysteine levels cannot be explained on the basis of poor hospital nutrition or smoking that may also raise homocysteine levels, but this effect is not large enough to explain our findings.