Abstract
Schizophrenia has been considered a disorder linked with faulty lipid homeostasis, and the proposed tool for assessment of these disruptions is the niacin skin flush test. The aims of the study were: 1. Create a new tool to analyze results of the niacin skin flush test more precisely and objectively. 2. Verify the utility of a self-created tool for differentiating between schizophrenia (SZ; n = 56), bipolar disorder (BD; n = 29) and healthy control (HC; n = 45) individuals. The proposed developed method, based on the Skin Reaction Measurement Computer System (SKINREMS), allows one to evaluate the response to the niacin skin flush test quickly and objectively. SKINREMS showed good accuracy in discriminating SZ from BD (with sensitivity 91% and specificity 72%), and SZ from HC (71% and 66%, respectively), and sufficient but not excellent accuracy in discriminating BD from HC (55% and 54%, respectively). The pathophysiological pathways and features shared by schizophrenia and bipolar disorder may be the reason for difficulties in fully discriminating between these two mental disorders using the niacin challenge test. The management of disruptions in the phospholipid metabolism and the inflammatory process could potentially become an individualized form of therapy in a subgroup of psychiatric patients.
Highlights
Schizophrenia is a chronic mental disorder affecting more than 21 million people worldwide [1]
We examined 130 persons: 56 patients with schizophrenia (SZ group), 29 patients with bipolar disorder (BD group), and 45 healthy volunteers as a control group (HC)
A significant age difference was found between the three groups: the participants from healthy control (HC) group were younger compared to both SZ and BD group (p = 0.0015)
Summary
Schizophrenia is a chronic mental disorder affecting more than 21 million people worldwide [1]. The severity of its psychopathological symptoms, including changes in thinking, perception, behavior, personality and functioning, makes schizophrenia a complex disorder, leading to low quality of life and disability [2]. Many theories have been proposed over the years to explain the pathogenesis of schizophrenia. There is the membrane hypothesis of schizophrenia, formulated by David Horrobin, with a large body of evidence supporting its validity [3]. Horrobin had concentrated his research on the biochemistry of lipids and their metabolism [4]. Phospholipase A2 (PLA-2) is an enzyme engaged in releasing fatty acids from the phospholipids of cell membranes (mainly arachidonic acid, AA)
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