The Link Between Hyperhomocysteinemia and Methylenetetrahydrofolate Reductase Polymorphism in Children and Adolescents with Psychotic Disorders. Summary of the Doctoral Thesis

Abstract

Homocysteine (hereinafter – Hcy) was first described by Butz and du Vigneud in 1932. The increased level of Hcy has been connected with the elevated risk of illness of heart’s blood-vessels (myocardial infarction, stroke), the disorder of development of a neural tube, pregnancy side effects, as well as mental diseases. In the beginning, in psychiatry, Hcy was studied in connection with diseases of dementia. However, in the lasts there are data on a possible role of the increased level of Hcy also in development of schizophrenia and temper disorders. The goal of the study was to get information about the serum Hcy level and its changes in dynamics, as well as a possible connection between Hcy level and polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene C677T and peculiarities of clinical pace of schizophrenia spectrum disorders for children and teenager with schizophrenia, temper disorders and to compare the data with the control group. For the study, we have used 118 patients from Children’s Psychiatric Hospital. The 1st group (20 patients): paranoid schizophrenia – continuous; the 2nd group (40 patients): paranoid schizophrenia - episodic with residual symptoms; the 3rd group (30 patients): simple schizophrenia; the 4th group (28 patients): patients with affective spectrum disorders (depressive syndrome with anxiety, mixed affective disorders and depressive syndrome without anxiety) and in the control group – 94 children and adolescents (the 5th group: intact). In the study it was stated that the average Hcy level for patients of schizophrenia spectrum disorders was 11.94 ± 5.6 μmol/L, for the patients with temper disorders - 11.26 ± 3.3 μmol/L, but for the patients in the control group - 7.47 ± 2.9 μmol/L. These data testify that higher Hcy level is for patients with a harder pace of schizophrenia spectrum disorders (continuous pace of paranoid schizophrenia (13.9 ± 5.2 μmol/)L, episodic pace paranoid schizophrenia (13.29 ± 6.5 μmol/L)) (r = 0.56; p < 0.01). In these two groups of schizophrenia spectrum disorders patients statistically credibly higher Hcy level was for patients who are heterozygous carriers of MTHFR gene mutation C677T (r = 0.58; p<0.01). In the other groups, the changes of Hcy level were stated depending on the existing genotype. It was also stated, that Hcy level is significantly higher for patients with schizophrenia spectrum disorders and with affective disorders whose disease pace was harder; it was with more explicit affective saturation (higher anxiety level). The data of the study testify on the connection that exists between polymorphism of MTHFR gene and Hcy level, as well as the type of schizophrenia spectrum disorders. It will give a possibility to forecast more precisely the clinical pace of schizophrenia spectrum disorders already in the first episode of the disease. The patients with MTHFR gene mutations C677T at heterozygous or homozygous state and more severe disease pace need careful choice of medication, as well as regular control of somatic health condition for control of side effects of possible medication, since these patients have an increased risk for development of health disorders connected with the increased Hcy level.