Serum creatine kinase levels in untreated hospitalized adolescents during acute psychosis.
OBJECTIVE
Psychosis-associated creatine kinase (CK)-emia (PACK) is a common and pronounced laboratory abnormality that accompanies adult psychotic conditions. Adult PACK is a relatively consistent individual trait. The authors investigated whether psychotic adolescents also present with such PACK characteristics.


METHODS
Participants were 127 newly admitted, drug-free, psychotic Israeli adolescents. Measures were baseline psychotic severity, serum creatine kinase (CK0), lactate dehydrogenase (LDH0), glutamate oxaloacetate transaminase (SGOT0), white blood cell count (WBC0), urine myoglobulin, and the repeated CK (RepCK) measurements taken during recurrent psychotic episodes.


RESULTS
Schizophrenia was the prevalent diagnosis (53%). CK0 levels did not correlate with the severity of the psychotic symptoms. Twenty-one percent of patients had a CK0 level >1,000 IU/L. CK0 and RepCK levels were higher in males than in females (p < or = .001) and in Jewish Sephardi patients than in Ashkenazi patients (p < .007). There was no difference by diagnosis. Logarithmic (Ln) CK0 correlated with RepCK, SGOT0, LDH0, and WBC0 (r = +0.32-0.74, p < .001) but correlated inversely with serum cholesterol0 (r = -0.36, p = .002) in males. Even prominent PACK was not associated with myoglobinuria. These findings remained significant among the younger patients (aged <18 years). In males from this subgroup, LnCK0 also correlated with age (p < .007) but not with weight.


CONCLUSIONS
In psychotic adolescents, PACK is common, is more prevalent among males, is independent of diagnosis, is influenced by ethnicity, and tends to recur.
Hermesh
Haggai
H
Geha Psychiatric Hospital and Felsenstein Medical Research Center, Rabin Medical Center, Petah Tiqva, Israel. hermesh@post.tau.ac.il
Stein
Daniel
D
Manor
Iris
I
Shechtmann
Tatiana
T
Blumensohn
Rachel
R
Meged
Sorin
S
Shiloh
Roni
R
Benjamini
Yoav
Y
Weizman
Abraham
A
D000293:Adolescent / Q000502:physiology*; D000328:Adult; D002648:Child; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011618:Psychotic Disorders / Q000097:blood* / Q000453:epidemiology; D012044:Regression Analysis; D012559:Schizophrenia / Q000097:blood* / Q000453:epidemiology; D017678:Sex Distribution
D003402:Creatine Kinase