Case Report

Vol. 62 No. 2 (2024): Neuropsychiatric Investigation

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

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Balaswamy Reddy
Alessandra Nocera
Renato de Filippis
Soumitra Das

Abstract

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.


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