RECURRENCE PATTERN OF SERUM CREATINE-PHOSPHOKINASE LEVELS IN REPEATEDACUTE-PSYCHOSIS

Background: Elevated serum creatine phosphokinase (CPK)(MM) level is f requently Sound in acute psychosis. Theories relate this CPKemia to ps ychomotor agitation and medication. We hypothesized that psychosis-rel ated CPKemia observed in individual patients is relatively consistent. Methods: Ninety psychotic patients were studied; 83% were schizophren ics (Brief Psychiatric Rating Scale scores greater than or equal to 40 ) whose serum CPKMM levels were recorded during two or more different acute psychoses. The serum CPKMM levels used were the maximal levels m onitored during the beginning of each hospitalization. The last CPK me asurement in a circumscribed period was defined as the index serum CPK level (IndCPK). The mean of all other individual maximal CPK measurem ents during other psychotic episodes was defined as the average CPK (A vgCPK). Results: Multiple linear regression analysis showed a signific ant correlation of natural logarithm (Ln) of (IndCPK with Ln(AvgCPK), as well as with gender (coefficient = .65 and .63, p < .0001 and p < . 01, respectively). There were significantly higher IndCPK levels among male patients than among female patients (p less than or equal to .00 1), A relatively consistent individual pattern of serum CPKMM levels d uring repeated acute psychotic episodes was observed. Conclusions: Ser um CPKMM levels and gender were found to be good predictors of maximal serum CPKMM levels during every repeated acute psychotic episode, Hig h IndCPK levels are probably risk factors for neuroleptic malignant sy ndrome. (C) 1998 Society of Biological Psychiatry.