Patients with schizoaffective disorder may have decreased levels of plasminogen activator inhibitor when compared with patients with schizophrenia, patients with affective disorder, or healthy controls, according to a study published in the Asian Journal of Psychiatry.

Researchers of this prospective, case-controlled study examined levels of tissue plasminogen activator and plasminogen activator inhibitor in patients with acute psychotic episodes and healthy controls. Patients being treated at an inpatient facility were categorized based on diagnosis into either schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, or major depressive disorder with psychotic features cohorts. Data collection included demographics, basic clinical evaluations, laboratory testing, psychometric data, current medication, and substance abuse history. Participants in the healthy control cohorts were age, gender, and race matched and completed baseline lab tests.

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This study included 9 patients in the schizophrenia cohort, 6 patients in the major depressive disorder cohort, 21 patients in the schizoaffective disorder cohort, 6 patients in the bipolar disorder cohort, and 20 participants in the healthy control cohort. Overall, the levels of tissue plasminogen activator were 2.99 ng/mL in the patient cohorts and 3.37 ng/mL in the control cohort, and the levels of plasminogen activator inhibitor were 31.12 ng/mL in the patient cohorts and 45.92 ng/mL in the control cohort.

A significant difference was found in plasminogen activator inhibitor levels between patients who are Asian and patients who were not Asian (P =.009), and between the different psychiatric cohorts (P =.005) with the schizoaffective cohort having significantly lower plasminogen activator inhibitor than the control cohort (P =.03).

Limitations of this study include the relatively small sample size for each psychiatric cohort, including patients who were not drug naive, laboratory tests not being completed to assess hyperhomocysteinemia or the presence antiphospholipid antibodies which can affect plasminogen activator inhibitors, and genetic analyses not being performed to detect polymorphisms.

The researchers concluded that “preliminary data suggest the possibility of a relationship between [plasminogen activator inhibitors] and schizoaffective disorder, with the additional suggestion that these results may be more pronounced in Asian patients with schizoaffective disorder.”

Reference

Elmi S, Sahu G, Malavade K, Jacob T. Role of tissue plasminogen activator and plasminogen activator inhibitor as potential biomarkers in psychosis [published online May 13, 2019]. Asian J Psychiatr. doi: 10.1016/j.ajp.2019.05.021