Plasma and Tissue Trace Element Levels in Drug Naïve Patients with Schizophrenia in a Tertiary Health Facility in Southwest Nigeria.

BACKGROUND: Trace elements are involved in oxidation reduction reactions in the body, including the central nervous system. The relationship between trace elements and psychiatric disorders have not been extensively investigated in the local population. We assessed the relationships between selected trace elements and schizophrenia. METHODS: A cross-sectional study of 70 newly diagnosed participants with schizophrenia, mean age = 33.6 ±10.7 years were recruited by simple random sampling. Sixty age-matched healthy subjects, mean age of 34.2 ± 7.9 years were recruited as control. Plasma Zn, Cu, Mn and Se were measured using atomic absorption spectrophotometer while toe nail Zn, Cu, Mn and Se were measured using inductively coupled plasma optical emission spectroscopy in both participants and controls. Illness severity was assessed using PANSS score. RESULTS: Mean plasma Zn, Cu and Mn were significantly lower in patients with schizophrenia than in control (p<0.001) while mean concentration of plasma Se was significantly higher in patients with schizophrenia than in control (p<0.001). Mean concentration of toenail Zn, Cu and Mn were significantly lower among schizophrenic group than in control group (p<0.001), however, mean toe nail Se level was similar in schizophrenic and control groups. In logistic regression, low plasma levels of Zn (Odds Ratio = 2.296, p<0.001), Cu (p<0.001), Mn (p<0.001) and Se (p<0.001) were independently associated with schizophrenia. There was no significant relationship between plasma Zn, Cu, Mn and Se and severity of illness using PANSS score. CONCLUSION: There is a possibility that low levels of Zn, Cu and Mn are involved in the aetiopathogenesis and progression of schizophrenia.

CONTEXTE: Les oligo-éléments participent aux réactions d'oxydoréduction dans l'organisme, y compris dans le système nerveux central. La relation entre les oligo-éléments et les troubles psychiatriques n'a pas été étudiée de façon approfondie dans la population locale. Nous avons évalué les relations entre certains oligo-éléments et la schizophrénie. MÉTHODES: Une étude transversale a été menée auprès de 70 participants atteints de schizophrénie, dont l'âge moyen était de 33,6 ± 10,7 ans, recrutés par échantillonnage aléatoire simple. Soixante sujets sains appariés selon l'âge, âgés en moyenne de 34,2 ± 7,9 ans, ont été recrutés comme témoins. Le Zn, le Cu, le Mn et le Se du plasma ont été mesurés à l'aide d'un spectrophotomètre d'absorption atomique, tandis que le Zn, le Cu, le Mn et le Se des ongles des orteils ont été mesurés à l'aide d'une spectroscopie d'émission optique à plasma à couplage inductif chez les participants et les témoins. La gravité de la maladie a été évaluée à l'aide du score PANSS. RÉSULTATS: La concentration plasmatique moyenne de Zn, Cu et Mn était significativement plus faible chez les patients atteints de schizophrénie que chez les témoins (p<0,001), tandis que la concentration moyenne de Se était significativement plus élevée chez les patients atteints de schizophrénie que chez les témoins (p<0,001). La concentration moyenne de Zn, Cu et Mn étaient significativement plus faibles dans le groupe schizophrène que dans le groupe témoin (p<0,001), cependant, le niveau moyen de Se dans les ongles des orteils était similaire dans les groupes schizophrènes et témoins. Dans la régression logistique, de faibles niveaux plasmatiques de Zn (Odds Ratio = 2,296, p<0,001), Cu (p<0,001), Mn (p<0,001) et Se (p<0,001) étaient indépendamment associés à la schizophrénie. Il n'y avait pas de relation significative entre le Zn, Cu, Mn et Se plasmatiques et la gravité de la maladie selon le score PANSS. CONCLUSION: Il est possible que de faibles niveaux de Zn, Cu et Mn soient impliqués dans l'étiopathogénie et la progression de la schizophrénie. Mots clés: Spectroscopie d'absorption atomique, spectroscopie d'émission optique du plasma à couplage inductif, score PANSS (Positive and Negative Syndrome Scale), schizophrénie, oligo-éléments.

The impact of psychological illness on outcome of corrosive esophageal injury.

PURPOSE OF STUDY: Esophageal stricture is a debilitating condition with significant morbidity and mortality, occurring often as a complication of the ingestion of corrosives. In the adult, majority of cases are intentional whilst being accidental in the pediatric population. We therefore sought to describe the circumstances of intentional corrosive ingestion and determine the presence and impact of psychiatric illness on the outcome of management. MATERIALS AND METHODS: A retrospective analysis of case folders of patients managed with this condition over a ten-year period (2000-2009) was done by comparing sociodemographics and outcome of management in patients with and without psychiatric disorders. RESULTS: Twenty seven cases were reviewed. Mean age was 30.7 (SD =16.01), with a M:F ratio of 1.25:1.86.2% had a diagnosable psychiatric condition, the most common being depression in 55.6% of the patients. Caustic soda (55.6%) was the most common corrosive ingested. There was a significant difference in mean duration before presentation in patients with (1.7 days) and without (6.6 days) previous psychiatric illness (P = 0.01). A significant positive association was also found between surgical outcome and previous history of psychiatric disorder (P = 0.02). CONCLUSION: Early recognition of psychosocial distress is important to prevent deliberate self-harm. Counter-intuitively, a previous history of psychopathology limits esophageal injury by early presentation and therefore improve chances of a good surgical outcome.

Erectile dysfunction in a sample of patients attending a psychiatric outpatient department.

To assess the prevalence of erectile dysfunction among a sample of patients attending a psychiatric clinic, we administered the International Index of Erectile Function on 108 male patients attending the clinic. We also obtained sociodemographic and clinical variables from the patients. The mean age of the patients studied was 39.6 (s.d.=11.6), with a mean duration of illness of 10.24 (s.d.=8.2) years. There were 46.8% schizophrenics; other diagnoses include bipolar affective disorder, recurrent depressive disorder and substance use disorder. The prevalence of erectile dysfunction was 83%. Age, marital status, current medications and the presence of comorbid medical conditions were significantly associated with erectile dysfunction; however, only age and marital status significantly predicted erectile dysfunction. We concluded that erectile dysfunction is highly prevalent among patients attending the psychiatric clinic, as such inquiries about sexual function should be routinely carried out by clinicians.