The Coexistence of Oculocutaneous Albinism with Schizophrenia.

Alicia L Tsai,Davin Agustines

doi:10.7759/cureus.6617

Abstract

Oculocutaneous albinism (OCA) is an extremely rare skin disorder which occurs in 0.005% of the world population, whereas schizophrenia is a rare mental illness which affects 1% of the world population. Researchers have spent much time searching for the causes of schizophrenia, as they are still largely unknown. It was previously hypothesized that schizophrenia could be caused by a defect in melatonin metabolism, leading to increased melanin production and the production of hallucinogenic agent. However, this implies that albinos would be protected against schizophrenia (since they have little to no melanin production), and although rare, there have been several case reports of albinos with schizophrenia, refuting this hypothesis. Following their discovery of schizophrenic albinos, several researchers have instead wondered whether schizophrenia and albinism could actually be genetically linked. To further this discussion, we present a case report of a 25-year-old African-American male with OCA2 and schizophrenia. He was hospitalized after his mother discovered the existence of a BB that was lodged in his forehead from a failed suicide attempt in response to command auditory hallucinations. The BB was removed during his hospitalization, and he was psychiatrically stabilized on a combination of risperidone, lithium, and escitalopram.

Highlights

Oculocutaneous albinism (OCA) is an autosomal recessive disorder defined by little to no melanin production in the eyes, skin, and hair, and is extremely rare, affecting 0.005% of the world’s population [1]
Oculocutaneous albinism (OCA) is an extremely rare skin disorder which occurs in 0.005% of the world population, whereas schizophrenia is a rare mental illness which affects 1% of the world population
We hereby present a case of schizophrenia in a young albino male and will further the discussion exploring the fate of the original Greiner and Nicholson hypothesis and how modern techniques could point to a possible linkage of albinism and a certain subtype of schizophrenia

Summary

Introduction

Oculocutaneous albinism (OCA) is an autosomal recessive disorder defined by little to no melanin production in the eyes, skin, and hair, and is extremely rare, affecting 0.005% of the world’s population [1]. The patient was admitted with symptoms of auditory hallucinations, paranoid delusions of people stalking him and stealing his thoughts, self-neglect, depression, and suicidal thoughts, which, according to his mother had increased when he became medication noncompliant He had been hospitalized and discharged one month prior at a different facility, when he had shot himself in the forehead with a BB gun in response to command auditory hallucinations. The patient was started on risperidone, which was uptitrated to 6 mg daily, and escitalopram at 10 mg daily for ongoing depressed mood This medication combination lessened the intensity of auditory hallucinations significantly, but he remained very depressed and isolative on the inpatient psychiatric ward, and continued to express thoughts of hopelessness. He returned home with his mother after his positive, cognitive, and negative symptoms of schizophrenia lessened to a degree that he no longer expressed any hopelessness or wishes to die

Discussion

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Disclosures

Findings

Spritz RA

Baron M