Neuropsychiatric Investigation
Case Report

Clinical Association Between Psychotic Symptoms and the Gilbert Syndrome: A Case Report


Department of Psychiatry, Junior Resident, National Institute of Mental Health and Neuro Sciences, Bengaluru, India


Department of Studies on Language and Culture, University of Modena and Reggio Emilia, Modena, Italy


Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy


University Magna Graecia of Catanzaro, Catanzaro, Italy


Psychiatry Unit, Department of Health Science, University Magna Graecia of Catanzaro, Catanzaro, Italy


Department of Psychiatry, Senior Resident, NIMHANS, Bengaluru, India

Neuropsychiatric Investigation 2024; 62: 73-75
DOI: 10.5152/NI.2024.23019
Read: 162 Downloads: 105 Published: 25 June 2024

Modern research in psychiatry is increasingly focusing on the possible identification of potentially useful biomarkers for early and differential diagnosis and patient-tailored therapy. In this context, old and new biomarkers are gaining attention, and bilirubin could represent a low-cost and widespread tool in this regard. In the following paper, we present a case report of a patient with juvenile-onset schizophrenia successfully treated with oral risperidone on 2 separate occasions, whose clinical exacerbation phases overlapped with hyperbilirubinemia peaks, while comfort phases were associated with serum bilirubin within the normal range. The patient was later diagnosed with Gilbert’s syndrome, a benign, congenital condition of hyperbilirubinemia, with alternating phases of mostly asymptomatic bilirubin levels. This case highlights a possible relationship between psychotic symptoms and plasma bilirubin levels. While not representing by itself a sufficient condition to determine a relationship between the 2 phenomena, it poses a relevant question for future clinical and research investigations.

Cite this article as: Reddy B, Nocera A, de Filippis R, Das S. Clinical association between psychotic symptoms and the Gilbert syndrome: A case report. Neuropsychiatr Invest. 2024;62(2):73-75.

EISSN 2792-0070