Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP)
<b>Introduction:</b> Secondary schizophrenia spectrum disorders (SSDs) have clearly identifiable causes. The Department for Psychiatry and Psychotherapy at the University Hospital Freiburg has continued to expand its screening practices to clarify the organic causes of SSDs. This retrosp...
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MDPI AG
2020-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/9/691 |
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| author | Dominique Endres Miriam Matysik Bernd Feige Nils Venhoff Tina Schweizer Maike Michel Sophie Meixensberger Kimon Runge Simon J. Maier Kathrin Nickel Karl Bechter Horst Urbach Katharina Domschke Ludger Tebartz van Elst |
| author_facet | Dominique Endres Miriam Matysik Bernd Feige Nils Venhoff Tina Schweizer Maike Michel Sophie Meixensberger Kimon Runge Simon J. Maier Kathrin Nickel Karl Bechter Horst Urbach Katharina Domschke Ludger Tebartz van Elst |
| author_sort | Dominique Endres |
| collection | DOAJ |
| description | <b>Introduction:</b> Secondary schizophrenia spectrum disorders (SSDs) have clearly identifiable causes. The Department for Psychiatry and Psychotherapy at the University Hospital Freiburg has continued to expand its screening practices to clarify the organic causes of SSDs. This retrospective analysis was carried out to analyze whether a comprehensive organic diagnostic procedure could be informative in patients with SSDs. <b>Methods and Participants:</b> The “Freiburg Diagnostic Protocol in Psychosis” (FDPP) included basic laboratory analyses (e.g., thyroid hormones), metabolic markers, pathogens, vitamin status, different serological autoantibodies, rheumatic/immunological markers (e.g., complement factors), cerebrospinal fluid (CSF) basic and antineuronal antibody analyses, as well as cranial magnetic resonance imaging (cMRI) and electroencephalography (EEG). The findings of 76 consecutive patients with SSDs (55 with paranoid–hallucinatory; 14 with schizoaffective; 4 with hebephrenic; and 1 each with catatonic, acute polymorphic psychotic, and substance-induced psychotic syndromes) were analyzed. <b>Results:</b> Overall, vitamin and trace element deficiency was identified in 92%. Complement factor analyses detected reduced C3 levels in 11%. Immunological laboratory alterations were detected in 76%. CSF analysis revealed general alterations in 54% of the patients, mostly with signs of blood–brain barrier dysfunction. cMRI analyses showed chronic inflammatory lesions in 4%. Combination of EEG, cMRI, and CSF revealed alterations in 76% of the patients. In three patients, autoimmune psychosis was suspected (4%). <b>Discussion:</b> On the basis of these findings, we conclude that a comprehensive diagnostic procedure according to the FDPP in patients with SSD is worthwhile, considering the detection of secondary, organic forms of SSDs, as well as alterations in “modulating factors” of the disease course, such as vitamin deficiency. Larger studies using comprehensive diagnostic protocols are warranted to further validate this approach. |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T16:21:26Z |
| publishDate | 2020-09-01 |
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| series | Diagnostics |
| spelling | doaj.art-4f907650234140ea98872e014f4b41492023-11-20T13:38:08ZengMDPI AGDiagnostics2075-44182020-09-0110969110.3390/diagnostics10090691Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP)Dominique Endres0Miriam Matysik1Bernd Feige2Nils Venhoff3Tina Schweizer4Maike Michel5Sophie Meixensberger6Kimon Runge7Simon J. Maier8Kathrin Nickel9Karl Bechter10Horst Urbach11Katharina Domschke12Ludger Tebartz van Elst13Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanyDepartment of Rheumatology and Clinical Immunology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanyDepartment of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanyDepartment for Psychiatry and Psychotherapy II, Ulm University, Bezirkskrankenhaus Günzburg, 89312 Günzburg, GermanyDepartment of Neuroradiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, GermanySection for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany<b>Introduction:</b> Secondary schizophrenia spectrum disorders (SSDs) have clearly identifiable causes. The Department for Psychiatry and Psychotherapy at the University Hospital Freiburg has continued to expand its screening practices to clarify the organic causes of SSDs. This retrospective analysis was carried out to analyze whether a comprehensive organic diagnostic procedure could be informative in patients with SSDs. <b>Methods and Participants:</b> The “Freiburg Diagnostic Protocol in Psychosis” (FDPP) included basic laboratory analyses (e.g., thyroid hormones), metabolic markers, pathogens, vitamin status, different serological autoantibodies, rheumatic/immunological markers (e.g., complement factors), cerebrospinal fluid (CSF) basic and antineuronal antibody analyses, as well as cranial magnetic resonance imaging (cMRI) and electroencephalography (EEG). The findings of 76 consecutive patients with SSDs (55 with paranoid–hallucinatory; 14 with schizoaffective; 4 with hebephrenic; and 1 each with catatonic, acute polymorphic psychotic, and substance-induced psychotic syndromes) were analyzed. <b>Results:</b> Overall, vitamin and trace element deficiency was identified in 92%. Complement factor analyses detected reduced C3 levels in 11%. Immunological laboratory alterations were detected in 76%. CSF analysis revealed general alterations in 54% of the patients, mostly with signs of blood–brain barrier dysfunction. cMRI analyses showed chronic inflammatory lesions in 4%. Combination of EEG, cMRI, and CSF revealed alterations in 76% of the patients. In three patients, autoimmune psychosis was suspected (4%). <b>Discussion:</b> On the basis of these findings, we conclude that a comprehensive diagnostic procedure according to the FDPP in patients with SSD is worthwhile, considering the detection of secondary, organic forms of SSDs, as well as alterations in “modulating factors” of the disease course, such as vitamin deficiency. Larger studies using comprehensive diagnostic protocols are warranted to further validate this approach.https://www.mdpi.com/2075-4418/10/9/691schizophreniapsychosisautoimmune psychosisscreeningantibodycerebrospinal fluid |
| spellingShingle | Dominique Endres Miriam Matysik Bernd Feige Nils Venhoff Tina Schweizer Maike Michel Sophie Meixensberger Kimon Runge Simon J. Maier Kathrin Nickel Karl Bechter Horst Urbach Katharina Domschke Ludger Tebartz van Elst Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP) Diagnostics schizophrenia psychosis autoimmune psychosis screening antibody cerebrospinal fluid |
| title | Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP) |
| title_full | Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP) |
| title_fullStr | Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP) |
| title_full_unstemmed | Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP) |
| title_short | Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP) |
| title_sort | diagnosing organic causes of schizophrenia spectrum disorders findings from a one year cohort of the freiburg diagnostic protocol in psychosis fdpp |
| topic | schizophrenia psychosis autoimmune psychosis screening antibody cerebrospinal fluid |
| url | https://www.mdpi.com/2075-4418/10/9/691 |
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