A red cell membrane abnormality in a subgroup of schizophrenic patients: evidence for two diseases.

There are several reports of abnormalities in fatty acids in brain and blood phospholipids in schizophrenic patients. In order to see if the broad categories of negative and positive schizophrenia were linked to specific changes in fatty acids, an initial study was made of patients showing severe symptoms of these two types. Thirteen patients had persistent chronic negative symptoms of apathy and withdrawal while 12 patients had persistent positive symptoms of either thought disorder or hallucinations and delusions. The positive and negative groups were matched for length of history and drug exposure. Negative symptoms were associated with high levels of saturated fatty acids and low levels of long-chain unsaturates in red blood cell (RBC) membranes, while the positive symptom patients showed the opposite picture. In order to see if this bimodal distribution would be found in patients diagnosed as schizophrenic but without classification of symptoms, we examined frequency distribution curves for fatty acids in plasma and in RBC membranes in 68 individuals classified as schizophrenics and 259 normal individuals. A bimodal distribution was found for 20- and 22-carbon unsaturated fatty acids in RBC membranes from the schizophrenics; the same fatty acids in normal RBC membranes showed an unimodal distribution.