Psychosis and hepatic pathology

An investigation reveals a striking relationship between suffering the first episode of psychosis and the level of risk of developing liver disease.

People who have experienced a first episode of psychosis are at high risk of developing short-term liver disease, specifically hepatic steatosis (also known as fatty liver disease). This is the conclusion of a collaborative study led by researchers from the Center for Biomedical Research in the Mental Health Network (CIBERSAM) at the Virgen del Rocío University Hospital in Seville – Institute of Biomedicine of Seville (IBIS), and the Center for Biomedical Research in the Network of Liver and Digestive Diseases (CIBEREHD) at the Marqués de Valdecilla University Hospital – Valdecilla Health Research Institute (IDIVAL), all these entities in Spain.

“Patients who suffer a first episode of psychosis have a higher risk of weight gain and metabolic disorders such as diabetes, dyslipidemia, or metabolic syndrome,” explains Javier Vázquez Bourgon, a CIBERSAM researcher at the Marqués de Valdecilla University Hospital (Santander). and the Valdecilla Health Research Institute (IDIVAL) and one of the coordinators of this work. In the general population, it is known that these metabolic alterations are closely associated with the appearance of one of the most common liver diseases, fatty liver (hepatic steatosis), which can evolve into more serious and chronic forms of liver disease. “Given that patients with psychosis have a higher risk of presenting weight gain and metabolic alterations, the objective of this study was to see if they also present this liver involvement more frequently,” he says.

To do this, this research analyzed data from 160 people who had suffered a first episode of psychosis, comparing them with 66 individuals without mental pathology, as a control group (“normal” group). In these patients, metabolic and hepatic changes were evaluated over 3 years, through the fatty liver index (FLI).

“The study found that, within the first 3 years from the onset of their first psychotic episode, up to a fifth of the patients (21.9%) developed fatty liver,” explains Javier Crespo, group leader of the CIBEREHD at the Hospital Marqués de Valdecilla – IDIVAL, where this work has been carried out. In contrast, only 3% of the individuals without psychosis belonging to the control group of the study presented hepatic steatosis in that period.

“Furthermore, the presence of fatty liver was associated with a worse evolution in metabolic parameters, and with the appearance of Metabolic Syndrome and high blood pressure in patients with this mental health disorder”, adds the CIBEREHD researcher.

“Thanks to this research, we have more evidence of the association between psychosis and liver involvement, which emphasizes the importance of including in routine practice actions aimed at the early detection of metabolic pathology as well as liver pathology (hepatic steatosis) in patients with a first episode of psychosis”, points out Benedicto Crespo Facorro, head of the CIBERSAM group at the Virgen del Rocío Hospital and IBIS.

Benedicto Crespo Facorro (left) and Javier Vázquez Bourgon. (Photo: CIBERSAM / CIBEREHD)

“All these data represent an advance in the knowledge of the metabolic impact at the hepatic level in patients with psychosis”, the researchers conclude.

The study is titled “Elevated risk of liver steatosis in first-episode psychosis patients: Results from a 3-year prospective study.” And it is published in the academic journal Schizophrenia Research. (Source: CIBERSAM / CIBEREHD)