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J Clin Psychiatry 1997 Feb;58(2):74-8
Iron overload among a psychiatric outpatient population.
Feifel D, Young CW
Department of Psychiatry, University of California, San Diego, La
Jolla 92093-8620, USA.
BACKGROUND: Iron overload has been suggested to be an unrecognized
cause of psychiatric morbidity. This study sought to estimate the
prevalence of iron overload in a large outpatient psychiatric clinic.
METHOD: A retrospective review of screening blood chemistries was
conducted on 661 active outpatients at a large, university outpatient
psychiatric clinic to identify elevated iron status results (plasma
iron, percentage of iron saturation) suggestive of iron overload.
Patients with positive profiles were asked to undergo a subsequent
blood chemistry to confirm positive results (plasma iron, percentage
of iron saturation, plus plasma ferritin). Patients with positive
repeated iron chemistry results were considered likely candidates for
iron overload. RESULTS: Twenty-one patients (3.2%) were identified as
meeting one of the criteria suggestive of iron overload on initial
screening reports. Thirty-one percent of those who underwent
subsequent, confirmatory testing (5/16) continued to meet one of the
criteria. On the basis of these results, we estimated a 1% (3.2 x
0.31) prevalence rate of likely candidates for iron overload. A review
of these patients' charts indicated that they carried an unexpectedly
high rate of bipolar affective disorder (80%) as a diagnosis and were,
without exception, atypical in that they were resistant to
conventional psychiatric treatment and lacked a family history for
this disorder. The prevalence of positive iron overload profiles on a
routine blood chemistry was similar to the prevalence of positive
thyroid abnormalities based on TSH results in this population.
CONCLUSION: Blood chemistry profiles suggestive of iron overload may
be associated with a small portion of treatment-resistant psychiatric
patients. Routine screening for iron abnormalities, especially in
treatment-resistant patients, should be considered. Further studies
are required to determine the causal association, if any, between iron
excess and primary psychiatric illnesses.
PMID: 9062376, UI: 97216086
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