Serum Creatine Kinase in Acute Psychosis

Abstract

The enzyme creatine kinase (CK) is present in high concentration in skeletal and cardíac muscle and brain tissue (Dawson and Fine, 1967). Raised serum levels of the enzyme occur in skeletal muscle disease, following myocardial infarction and in hypothyroidism. Raised levels have also been demonstrated in acute cerebral disease (Acheson et al., 1965), but earlier suggestions that this might be due to leakage of enzyme from brain tissue have not been confirmed by isoenzyme separation studies (Dubo et al., 1967), which have shown that the excess enzyme came from striated muscle. Raised serum CK levels associated with acute psychosis have also been reported (Bengzon et al., 1966; Meitzer et al., 1969; Coffey et al., 1970; and Gosling et al., 1972). This has led to the suggestion that serum CK estimation could be used in the differential diagnosis of psychiatric patients (Meltzer et al., 1970; Gosling et al., 1972). Meitzer (1969) has also claimed that the biochemical abnormality reflects ‘a basic patho-physiological process common to the acute psychoses'.