Schizophrenia-Associated Idiopathic Unconjugated Hyperbilirubinemia (Gilbert's Syndrome).
J Clin Psychiatry 2000;61(11):868-871
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Background: Idiopathic unconjugated
hyperbilirubinemia (Gilbert's syndrome) is a benign
hyperbilirubinemia found in the general population. There has
been only 1 previous report of Gilbert's syndrome occurring in
schizophrenic patients. The present study was conducted to
determine the frequency of Gilbert's syndrome in schizophrenic
patients relative to patients with other psychiatric disorders.
Method: Plasma bilirubin concentrations of every
patient admitted to the psychiatric hospital during a 3-year
period were collected, and patients were examined to exclude all
other causes of hyperbilirubinemia. In addition, the psychiatric
symptoms of schizophrenic patients (ICD-10 criteria) with
hyperbilirubinemia were evaluated by the Positive and Negative
Syndrome Scale (PANSS).
Results: Schizophrenic patients showed a
significantly higher incidence of hyperbilirubinemia (p < .05)
relative to patients suffering from other psychiatric disorders,
and schizophrenic patients with hyperbilirubinemia showed
significantly higher scores on the positive and general
psychiatric subscales of the PANSS (p < .0001) than patients
Conclusion: The apparently higher frequency of
Gilbert's syndrome in schizophrenic patients may reflect a
relationship between hyperbilirubinemia and schizophrenic
psychosis. Hypothetical explanations, such as a possible genetic
disposition for Gilbert's syndrome, an increased vulnerability of
red cell membranes, and the role of estrogens in schizophrenic
patients, are discussed.