Mental health diagnoses in adults with phenylketonuria: a retrospective systematic audit in a large UK single centre

Orphanet Journal of Rare Diseases

Kamran Hussain¹  Boyd J. G. Strauss²  Gisela Wilcox³  George Altman³  Diane Green⁴ 

[1] Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK;Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK;Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia;Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK;The Mark Holland Adult Inherited Metabolic Disorders Unit, Ladywell Building, Salford Royal NHS Foundation Trust, Stott Lane, M6 8HD, Salford, UK;The Mark Holland Adult Inherited Metabolic Disorders Unit, Ladywell Building, Salford Royal NHS Foundation Trust, Stott Lane, M6 8HD, Salford, UK;

关键词: Phenylketonuria;    Phenylalanine;    Neuropsychiatric;    Mental health;    Depression;    Anxiety;    Mood swings;    Low mood;    Audit;    ESPKU guidelines;   

DOI  :  10.1186/s13023-021-02138-z

来源: Springer

【 摘 要 】

BackgroundRecently published European Society for Phenylketonuria (ESPKU) guidelines have recommended a lifelong diet with phenylalanine (Phe) control ≤ 600 μmol/L for phenylketonuria (PKU) patients. This study aimed to identify whether PKU adult patients are at a higher risk of mental health diagnoses if their 2-year average Phe level is higher than the ESPKU European guidelines. Published studies identified by a literature review showed that related studies have been published in American and European PKU study populations but not in the United Kingdom (UK) study populations. Previous studies also involved a smaller number of participants due to this being a rare disease.ResultsWe undertook a retrospective audit at a single large PKU centre in the UK. 244 adult PKU patients at the centre were included, 220 of which had a recorded Phe level. Approximately 75% of the patients in this study did not meet the ESPKU European guidelines for Phe control. A systematic search of the electronic patient record was undertaken looking for mental health diagnoses. Compared to two-year average Phe levels ≤ 600 μmol/L, PKU adult patients with two-year average Phe levels > 600 μmol/L were more likely to have diagnoses of low mood, depression, anxiety, or mood swings, but only low mood reached statistical significance (p < 0.05).ConclusionsPKU patients with two-year average Phenylalanine levels greater than ESPKU guidelines may be at greater risk of mental health diagnoses and symptoms. Many of these adult PKU patients will be lost to follow-up, and therefore may be receiving treatment for mental health conditions in the community. Multicentre UK studies and international collaborations are required to overcome low participant numbers in the study of this rare disease.

【 授权许可】

CC BY