Homocysteinemia as well as methylenetetrahydrofolate reductase polymorphism are associated with affective psychoses

In the recent years, elevated homocysteine plasma levels have been reported to represent a risk factor not only for atherosclerosis, but also to be associated with dementia, depression and–in a gender-specific manner–schizophrenia. Here, we explored a possible association between homocysteinemia and psychiatric disorders. Fasting homocysteine, vitamin B12 and folate were determined in an ethnically homogeneous female population with different psychiatric disorders. Homocysteine was not elevated in females suffering from schizophrenia (mean, 11.6 ± 5.8 μmol/l). As shown previously, increased homocysteine concentrations were associated not only with dementia of different aetiology (mean, 17.2 ± 6.7 μmol/l; χ 2 = 23.39, p < 0.001, compared to the schizophrenia group), but also with depressive disorders (mean, 12.9 ± 3.8 μmol/l; χ 2 = 6.88, p = 0.009). B12 and folate levels did not differ between different diagnostic groups. To further explore the connection between homocysteinemia and affective psychoses, a case–control study examining the C677T and the A1298C variants of methylenetetrahydrofolate reductase was conducted. The latter polymorphism not only was associated with affective psychoses in general, but also when divided in unipolar depression and bipolar affective disorder. In conclusion, we suggest that in females homocysteinemia is an unspecific risk factor for organic brain disorders like dementia, and possibly depression, but not for schizophrenia.