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Wernicke Encephalopathy in schizophrenia: a systematic review.

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Title: Wernicke Encephalopathy in schizophrenia: a systematic review.
Authors: Oudman, Erik, Wijnia, Jan W., Oey, Misha J., van Dam, Mirjam J., Postma, Albert
Source: International Journal of Psychiatry in Clinical Practice. Sep2021, Vol. 25 Issue 3, p233-237. 5p.
Subjects: Online information services, Schizophrenia, Systematic reviews, Wernicke's encephalopathy, Multiple human abnormalities, Dietary supplements, Terms & phrases, Psychosocial factors, Weight loss, MEDLINE, Vitamin B1, Ataxia, Disease risk factors
Abstract: In schizophrenia, patients can experience delusions or hallucinations regarding their food or health status, leading to diminished intake. Fasting or not eating a balanced diet can cause neurological complications after severe vitamin B1 malnourishment. The precise signs and symptoms of Wernicke's Encephalopathy (WE) in schizophrenia are not clear. Our aim, therefore, was to conduct a systematic review of the characteristics of WE in patients with schizophrenia. We conducted our search from inception using Mesh terms schizophrenia, Wernicke Encephalopathy, Korsakoff's syndrome. We searched Pubmed, ISI Web of Science, and Scopus. We defined WE as mental, oculomotor, and motoric alterations and thiamine deficiency; schizophrenia was defined as psychosis, hallucinations and/or delusions; adequate WE treatment as >500 mg/day intramuscular or intravenous. Our search yielded 15 WE cases. WE is characterised by a triad of mental status change, ocular signs and ataxia. In alcohol use disorder, this triad is present in 16% of the cases, but 12 out of the 15 published schizophrenia cases presented themselves with a full triad. Importantly, as an additional characteristic, patients often lost weight within a short period of time. The development of a full triad and additional symptomatology suggests a late recognition of signs and symptoms of WE in schizophrenia. Prophylactic thiamine checks and treatment in patients with schizophrenia are relevant, and if WE is suspected adequate parenteral thiamine supplementation is necessary. Only few cases of schizophrenia-related WE have been published in the literature, though challenges in diagnosing and recognising WE suggest that the vast majority of cases go undetected. Acute thiamine deficiency leads to Wernicke's Encephalopathy. Patients diagnosed with schizophrenia are at risk to develop Wernicke's Encephalopathy. Timely treatment with high doses of thiamine can adequately treat Wericke's Encephalopathy. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Psychiatry in Clinical Practice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Wernicke Encephalopathy in schizophrenia: a systematic review.
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  Data: <searchLink fieldCode="AR" term="%22Oudman%2C+Erik%22">Oudman, Erik</searchLink><br /><searchLink fieldCode="AR" term="%22Wijnia%2C+Jan+W%2E%22">Wijnia, Jan W.</searchLink><br /><searchLink fieldCode="AR" term="%22Oey%2C+Misha+J%2E%22">Oey, Misha J.</searchLink><br /><searchLink fieldCode="AR" term="%22van+Dam%2C+Mirjam+J%2E%22">van Dam, Mirjam J.</searchLink><br /><searchLink fieldCode="AR" term="%22Postma%2C+Albert%22">Postma, Albert</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Psychiatry+in+Clinical+Practice%22">International Journal of Psychiatry in Clinical Practice</searchLink>. Sep2021, Vol. 25 Issue 3, p233-237. 5p.
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  Data: <searchLink fieldCode="DE" term="%22Online+information+services%22">Online information services</searchLink><br /><searchLink fieldCode="DE" term="%22Schizophrenia%22">Schizophrenia</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Wernicke's+encephalopathy%22">Wernicke's encephalopathy</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+human+abnormalities%22">Multiple human abnormalities</searchLink><br /><searchLink fieldCode="DE" term="%22Dietary+supplements%22">Dietary supplements</searchLink><br /><searchLink fieldCode="DE" term="%22Terms+%26+phrases%22">Terms & phrases</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink><br /><searchLink fieldCode="DE" term="%22Weight+loss%22">Weight loss</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Vitamin+B1%22">Vitamin B1</searchLink><br /><searchLink fieldCode="DE" term="%22Ataxia%22">Ataxia</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink>
– Name: Abstract
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  Data: In schizophrenia, patients can experience delusions or hallucinations regarding their food or health status, leading to diminished intake. Fasting or not eating a balanced diet can cause neurological complications after severe vitamin B1 malnourishment. The precise signs and symptoms of Wernicke's Encephalopathy (WE) in schizophrenia are not clear. Our aim, therefore, was to conduct a systematic review of the characteristics of WE in patients with schizophrenia. We conducted our search from inception using Mesh terms schizophrenia, Wernicke Encephalopathy, Korsakoff's syndrome. We searched Pubmed, ISI Web of Science, and Scopus. We defined WE as mental, oculomotor, and motoric alterations and thiamine deficiency; schizophrenia was defined as psychosis, hallucinations and/or delusions; adequate WE treatment as >500 mg/day intramuscular or intravenous. Our search yielded 15 WE cases. WE is characterised by a triad of mental status change, ocular signs and ataxia. In alcohol use disorder, this triad is present in 16% of the cases, but 12 out of the 15 published schizophrenia cases presented themselves with a full triad. Importantly, as an additional characteristic, patients often lost weight within a short period of time. The development of a full triad and additional symptomatology suggests a late recognition of signs and symptoms of WE in schizophrenia. Prophylactic thiamine checks and treatment in patients with schizophrenia are relevant, and if WE is suspected adequate parenteral thiamine supplementation is necessary. Only few cases of schizophrenia-related WE have been published in the literature, though challenges in diagnosing and recognising WE suggest that the vast majority of cases go undetected. Acute thiamine deficiency leads to Wernicke's Encephalopathy. Patients diagnosed with schizophrenia are at risk to develop Wernicke's Encephalopathy. Timely treatment with high doses of thiamine can adequately treat Wericke's Encephalopathy. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of International Journal of Psychiatry in Clinical Practice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/13651501.2020.1819333
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        PageCount: 5
        StartPage: 233
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      – SubjectFull: Online information services
        Type: general
      – SubjectFull: Schizophrenia
        Type: general
      – SubjectFull: Systematic reviews
        Type: general
      – SubjectFull: Wernicke's encephalopathy
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      – SubjectFull: Multiple human abnormalities
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      – SubjectFull: Dietary supplements
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      – SubjectFull: Ataxia
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              Text: Sep2021
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