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S013-2

Hyperbilirubinemia and Neuroinflammation in Schizophenia: Evaluation of
Human Studies

Andi Jayalangkara Tanra

Hasanuddin University, Makassar, Indonesia

Background/Objective: Schizophrenia is a chronic and devastating illness,affects approximately
1% of the world population with the etiology that remains unclear.Strategies for schizophrenia
treatment are still developing in order to increase its effectivity. Coincedence of
hyperbilirubinemia,especially related to Gilbert’s Syndrome,and schizophrenia/psychotic
disorders,was reported in several studies although the pattern of this alteration is still
controversial.Bilirubin could induce microglia to release pro-inflamatory cytokine that cause
neuroinflammation which recently studied.However,no data are presented about this phenomenon in
Indonesia.Therefore,this study aims to investigate plasma bilirubin concentration in psychotic
spectrum

Method: In our study,we examined both the total bilirubin and direct bilirubin of every
schizophrenia patient admitted for the first time to Mental Hospital as period of January—July 2014,
with healthy people as control. Diagnostic criteria base on ICD10.Patients suffering from physical
diseases or substance abuse were excluded.Later,we examined the clinical symptoms and
improvement using the PANSS scale after administration of anti-psychotic
medication.Furthermore,we checked the lymphocyte profile from each sample

Result: As the results, out of 73 samples, we found that plasma UCB level was significantly elevated,
higher in psychotic patients, especially schizophrenic group, than in the control group. Total bilirubin
rate was slightly increased in schizophrenic group compare to the others and two samples in this
group showed hyperbilirubinemia. Moreover, there was a relationship between levels of blood
billirubin with clinical symptoms of schizophrenia , where there is a significant difference in PANSS
scores for positive symptoms and general psychopathology symptoms among schizophrenic patients
with high levels of billirubin with patients with normal billirubin levels . While the PANSS scores for
negative symptoms of schizophrenia are not found significant differences.

Conclusion: These results suggested that hyperbilirubinemia might play an important role in the
pathophisiology and therapeutic strategy of schizophrenia. Further investigations are needed to
ensure either the UCB elevation was related to GS or due to inflammatory effect.