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Increased Serum Calcium and Phosphorus with the ‘Switch’ into Manic or Excited Psychotic States

Published online by Cambridge University Press:  29 January 2018

John Scott Carman
Affiliation:
University of Alabama, School of Medicine, Birmingham, Alabama, 35294, U.S.A.
Robert M. Post
Affiliation:
Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland, U.S.A.
Deborah C. Runkle
Affiliation:
Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland, U.S.A.
William E. Bunney Jr
Affiliation:
Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland, U.S.A.
Richard Jed Wyatt
Affiliation:
Laboratory of Clinical Psychopharmacology, National Institute of Mental Health, Washington D.C., U.S.A.

Summary

Small but statistically significant increases in serum total calcium and serum inorganic phosphorus coincided with repeated onsets of psychotic agitation or mania in nine psychotic in-patients experiencing rapid cycles of illness. These increases were not accompanied by changes in magnesium or other constituents, which might suggest non-specific haemoconcentration. Similar increases in calcium or phosphorus were not present in patients without the same cycles of psychotic illness. The observed increases could neither be simulated nor altered by stress or activity, and it remains unclear whether they might be accounted for by dietary changes, sleep disruption, circadian phase shifts or by endocrine alterations.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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