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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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