Membrane abnormalities in the psychoses and affective disorders

Erythrocyte ghost phospholipid data were collected on 67 psychotic and/or manic patients and compared to a group of 35 age and sex matched controls. Patients meeting DSM-III criteria for schizophreniform disorder or schizophrenia but not mania showed a small but significant decrease in membrane phosphatidylcholine (PC). In 53 of the patients data were available on lithium transport across red cell membranes. Patients in the upper quartile of the PC distribution showed a significant (-47%) decrease in the 24 h in vitro lithium ratio as compared to patients in the lower PC quartile. This difference was due to an increase in Na-Li+ counterflow activity in the upper PC quartile and not to a change in passive lithium leak. These data illustrate one example of a possible relationship between membrane composition and a membrane function, counterflow activity, which has been associated with the underlying mechanism(s) of lithium action.