Disturbances of serine and glycine metabolism as a cause of episodic acute polymorphous psychoses

Psychiatrists are frequently confronted with psychoses that are difficult to classify. Many forms of these atypical psychoses have been described in European literature. They often have an acute onset and a tendency towards complete remission, albeit with an episodic course. Rich, multiform symptomatology is noted sometimes in addition to altered states of consciousness. In patients with a grossly impaired consciousness the psychiatrist has also to consider whether such a psychosis is due to organic factors or is functional (I). Even when morphologically demonstrable organic factors are excluded, the possibility of a reaction of the brain to subtle toxic factors disturbing the normal physico-chemical equilibrium without causing cellular damage has to be taken into account. An intermittent production of such toxins in the brain or the liver has been an attractive concept for many researchers to understand and account for the endogenous functional psychoses (2). In this thesis an attempt is made to provide clinical evidence for the endogenous synthesis of toxic factors which are causally related to some types of the atypical psychoses. The findings have led to a new classification of the group of poorly defined and previously unclassifiable psychoses.