title: Rapid cycling bipolar affective disorder and recurrent strokes secondary to high blood homocysteine.
abstract: BACKGROUND
  The interface between psychiatric disorders and organicity has been a matter for contentious debate.
  
  
  OBJECTIVE
  To report an interesting clinical case of moderate homocystinuria presenting with significant psychiatric and neurological deficits.
  
  
  METHODS
  A case report highlighting the impact of homocystinuria on producing intractable rapid cycling bipolar affective disorder.
  
  
  CONCLUSIONS
  Homocystinuria is a frequently missed cause for treatment-resistant bipolar affective disorder.
authors.affiliation: Mental Health Unit , South Essex Partnership University NHS Foundation Trust (SEPT) , Basildon Hospital, Basildon, Essex SS16 5NL , UK .
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Awara
authors.forename: Shazia
authors.initials: S
authors.lastname: Zahid
authors.forename: Manal O
authors.initials: MO
authors.lastname: Elnenaei
mesh_terms: D001714:Bipolar Disorder / Q000097:blood* / Q000150:complications*; D003863:Depression / Q000150:complications; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications* / Q000523:psychology
chemical_list: D006710:Homocysteine