Serum uric acid levels in first episode mania, effect on clinical presentation and treatment response: Data from a case control study

Asian J Psychiatr. 2018 Jun:35:15-17. doi: 10.1016/j.ajp.2018.04.030. Epub 2018 Apr 26.

Abstract

Bipolar disorder (BD) patients have increased serum Uric Acid (UA) levels as compared to their healthy counterparts. They also demonstrate higher impulsivity - while symptomatic, as well as when in remission. Impulsivity adds a risk of self-harming behavior to BD, and studies show that it increases with UA levels. Given this complex relationship, the current project aimed at comparing UA levels in first-episode mania patients with matched controls, and analyzes its relationship with impulsivity, symptom severity and disease prognosis. Thirty-one first-episode mania patients were assessed on BIS-11 and YMRS, serum uric acid levels were measured, and compared to matched controls. A follow up YMRS was rated after one month to evaluate the effects of treatment. We found significantly higher levels of UA in patients, which showed positive correlation with impulsivity and a negative correlation with symptom improvement at 1 month. The results of the study support a purinergic system dysfunction hypothesis in first-episode mania, and suggest its influence on impulsivity in this patient group. Further, the mentioned dysfunction appears to have a negative impact on treatment outcomes in such cases.

Keywords: Bipolar disorder; Mania; Purinergic system; Uric acid.

MeSH terms

  • Adolescent
  • Adult
  • Antimanic Agents / therapeutic use*
  • Bipolar Disorder / blood*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Severity of Illness Index
  • Treatment Outcome
  • Uric Acid / blood*
  • Young Adult

Substances

  • Antimanic Agents
  • Uric Acid