The following is a summary of “Lipid Alteration Signature in the Blood Plasma of Individuals With Schizophrenia, Depression, and Bipolar Disorder,” published in the January 2023 issue of Psychiatry by Tkachev, et al.

There is no diagnostic tool for severe mental problems that is therapeutically useful. However, lipids may serve as disease indicators. For a study, researchers sought to establish a reproducible profile of lipid changes in patients with schizophrenia (SCZ) that is independent of demographic and environmental factors and to look into its specificity about other psychiatric diseases, such as major depressive disorder (MDD) and bipolar disorder (BPD).

The multicohort case-control diagnostic investigation gathered plasma samples from mental health patients and healthy controls between July 17, 2009, and May 18, 2018. Inpatient and outpatient mental health hospitals in Western Europe (Germany and Austria [DE-AT]), China (CN), and Russia (RU) all participated in the study by recruiting volunteers as consecutive samples. The study included participants who had been diagnosed with SCZ, MDD, BPD, or a first psychotic episode according to the DSM-IV or the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, as well as healthy controls who were age- and sex-matched but had not received a mental health-related diagnosis. Between January 2018 and September 2020, samples and data were examined. The plasma lipidome composition was evaluated using liquid chromatography and untargeted mass spectrometry.

Around 980 patients with SCZ, BPD, MDD, or those experiencing their first psychotic episode (mean [SD] age: 36 [13] years; 510 male patients [52%]) and 572 controls (mean [SD] age: 34 [13] years; 323 male patients [56%]) had their blood lipid levels checked. The three sample cohorts revealed 77 lipids to be substantially different between those with SCZ (n = 436) and controls (n = 478). Changes were consistent across cohorts (CN and RU: [Pearson correlation] r = 0.75; DE-AT and CN: r = 0.78; DE-AT and RU: r = 0.82; P < 10^-38). A lipid-based predictive model with good diagnostic sensitivity distinguished patients with SCZ from controls (area under the receiver operating characteristic curve = 0.86-0.95). It was discovered that the lipidome abnormalities in BPD and MDD, which were evaluated in 184 and 256 individuals, respectively, were comparable to those of SCZ (BPD: r = 0.89; MDD: r = 0.92; P < 10^-79). Evaluation of identified changes in people who had their first psychotic episode and in SCZ patients who weren’t taking any medication showed a weak correlation with certain lipid-specific medications.

In the investigation, SCZ was linked with a consistent profile of plasma lipidome changes that were mostly shared with BPD and MDD and were unrelated to the severity of the symptoms, medications, or demographic or environmental factors. The lipid modification signature may serve as a trait marker for severe psychiatric diseases, showing the potential for it to be developed into a therapeutically useful diagnostic method.

Reference: jamanetwork.com/journals/jamapsychiatry/article-abstract/2800311