Serum Creatine Kinase Levels in Untreated Hospitalized Adolescents during Acute Psychosis

Objective: Psychosis-associated creatine kinase (CK)-emia (PACK) is a common and pronounced laboratory abnormality that accompanies adult psychotic conditions. Adult PACK is a relatively consistent individual trait. The authors investigated whether psychotic adolescents also present with such PACK characteristics. Method: Participants were 127 newly admitted, drug-free, psychotic Israeli adolescents. Measures were baseline psychotic severity, serum creatine kinase (CK₀), lactate dehydrogenase (LDH₀), glutamate oxaloacetate transaminase (SGOT₀), white blood cell count (WBC₀), urine myoglobulin, and the repeated CK (RepCK) measurements taken during recurrent psychotic episodes. Results: Schizophrenia was the prevalent diagnosis (53%). CK₀ levels did not correlate with the severity of the psychotic symptoms. Twenty-one percent of patients had a CK ₀ level >1,000 IU/L. CK₀ and RepCK levels were higher in males than in females (p ≤ .001) and in Jewish Sephardi patients than in Ashkenazi patients (p < .007). There was no difference by diagnosis. Logarithmic (Ln) CK₀ correlated with RepCK, SGOT₀, LDH₀, and WBC₀ (r = +0.32-0.74, p < .001) but correlated inversely with serum cholesterol₀ (r = -0.36, p =.002) in males. Even prominent PACK was not associated with myoglobinuria. These findings remained significant among the younger patients (aged <18 years). In males from this subgroup, LnCK₀ also correlated with age (p < .007) but not with weight. Conclusions: In psychotic adolescents, PACK is common, is more prevalent among males, is independent of diagnosis, is influenced by ethnicity, and tends to recur.