Uric acid levels in agitated mania and other agitated non-affective psychotic disorders

Abstract

Background: Uric Acid (UA) is an end product of purine metabolism which is transported via blood and is primarily excreted through kidneys. Elevated serum UA levels are found to be closely associated with agitation, not only present in healthy subjects but is also found in individuals suffering from organic or functional psychiatric illnesses in the form of aggression. Aim and Objective: Assessment and comparison of serum UA levels between patients with agitated mania and agitated non-affective psychotic disorders and correlation of serum UA levels with severity of mania and non-affective psychosis. Material and Methods: A cross-sectional study was conducted that compared serum UA levels in 100 in-patients (50 in each group) aged 18 years and above, of either sex, with International Classification of Mental and Behavioral Disorders-10th Edition Diagnostic Criteria for Research (ICD-10 DCR) diagnosis of mania and non-affective psychotic disorders, admitted in a state of acute agitation. Agitated Behavior Scale (ABS), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS) were applied for the assessment of the severity of agitation, mania, and psychosis respectively. Strength of association was obtained using fisher's exact test and unpaired-t-test. Severity scores obtained were correlated with serum UA levels using Pearson's correlation coefficient. Results: UA levels were found to be significantly higher in individuals suffering from mania than those with non-affective psychosis (p = 0.04). Similarly, a significant positive correlation was found between UA levels and YMRS scores (r = 0.34) (p = 0.01). Conclusion: UA level is found to be significantly higher in individuals with mania and correlates significantly positively with symptom severity.

Keywords

• uric acid
• agitation
• bipolar disorder
• mania
• non-affective psychosis