Oculocutaneous albinism and schizophrenia

The Coexistence of Oculocutaneous Albinism with Schizophrenia

Oculocutaneous albinism (OCA) is an extremely rare skin disorder which occurs in 0.005% of the world population, whereas schizophrenia is a rare mental illness which affects 1% of the world population. Researchers have spent much time searching for the causes of schizophrenia, as they are still largely unknown. It was previously hypothesized that schizophrenia could be caused by a defect in melatonin metabolism, leading to increased melanin production and the production of hallucinogenic agent. However, this implies that albinos would be protected against schizophrenia (since they have little to no melanin production), and although rare, there have been several case reports of albinos with schizophrenia, refuting this hypothesis. Following their discovery of schizophrenic albinos, several researchers have instead wondered whether schizophrenia and albinism could actually be genetically linked. To further this discussion, we present a case report of a 25-year-old African-American male with OCA2 and schizophrenia. He was hospitalized after his mother discovered the existence of a BB that was lodged in his forehead from a failed suicide attempt in response to command auditory hallucinations. The BB was removed during his hospitalization, and he was psychiatrically stabilized on a combination of risperidone, lithium, and escitalopram.

Psychiatric Morbidity among Subjects with Leprosy and Albinism in South East Nigeria: A Comparative Study

BACKGROUND

Skin, which is the largest organ in the body, carries immense psychological significance. Disfiguring skin disorders may impact negatively on the mental health of individuals.

AIM

This study compared the psychiatric morbidity of subjects with leprosy and albinism.

SUBJECTS AND METHODS

One hundred subjects with leprosy and 100 with albinism were interviewed. Sociodemographic questionnaire and General Health Questionnaire (GHQ-28) assessed the sociodemographic characteristics and psychiatric morbidity, respectively. GHQ positive cases and 10% of noncases for each group were interviewed with Mini International Neuropsychiatric Inventory for specific ICD-10 diagnoses.

RESULTS

Fifty-five percent (55/100) subjects with leprosy were GHQ positive cases while 41% (41/100) with albinism were GHQ positive cases. The risk of developing psychiatric morbidity was significantly higher in subjects with leprosy than in subjects with albinism (OR = 1.76, CI = 1.00 - 3.08, P = 0.04). The prevalence of specific psychiatric disorders among subjects with leprosy were depression 49% (49/100), generalized anxiety disorder (GAD) 18% (18/100), alcohol/drug abuse 16% (16/100), whereas in albinism depression was 51% (51/100), GAD 27% (27/100), and alcohol/drug abuse 7% (7/100). Male, married and uneducated subjects with leprosy had significantly higher psychiatric morbidity than the male, married and uneducated subjects with albinism, respectively.

CONCLUSION

Psychiatric morbidity was higher in subjects with leprosy than in subjects with albinism. Male, married and uneducated subjects with leprosy significantly had higher morbidity than male, married and uneducated subjects with albinism respectively.

Familial association of albinism and schizophrenia

Of three siblings in a family, one brother and one sister have both tyrosinase-negative oculocutaneous albinism and a psychotic disorder indistinguishable from schizophrenia. The two disorders may associate within families through genetic linkage or a failure of neurotransmitter homoeostasis.