Derangement of one-carbon metabolism in episodic schizoaffective psychoses

The so-called cycloid or degeneration psychoses form a subgroup of the vaguely defined schizoaffective psychotic disorders, or according to the DSM III criteria: "Psychotic Disorders Not Elswhere Classified" (295.40; 298.80; 295.70; 298.90). Recovery from these acute psychoses is always complete, though episodic recurrence is commonly observed. The clinical syndrome is characterized by a kaleidoscopic, polymorphous clinical picture, e.g. sudden mood swings, motility disturbances, states of pananxiety and ecstasy with visionary experiences, perfunctory delusional ideas and visual hallucinations. At the onset of the psychoses many patients experienced psychedelic phenomena. It was postulated that these patients suffered from an abnormality in one-carbon metabolism resulting in the formation of beta-carbolines which were held responsible for evoking the psychotic symptoms. Since serine is the principle donor for one-carbon units, serine was administered to nonsymptomatic patients. Two to three hours after the administration patients became psychotic again. Analysis of blood samples from these patients showed a decreased fasting plasma concentration of serine and an increased fasting plasma level of taurine. In addition a decreased formation of serine from glycine was found. These findings are in agreement with the postulated derangement of one-carbon metabolism. Moreover, the beta-carboline norharman was present in blood obtained during acute psychotic episodes and was not present in blood of nonsymptomatic patients nor in blood of healthy controls. No abnormal activities of enzymes were found in skin fibroblasts from these patients.(ABSTRACT TRUNCATED AT 250 WORDS)