Psychiatric Disorders Linked to Higher NA-OXS Levels

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Patients with dementias also had higher levels of NA-OXS, as did psychotic and bipolar disorders.

Patients with psychiatric disorders often have higher levels of oxidative stress-induced nucleic acid damage from oxidative stress (NA-OXS) compared to the general population.

A team, led by Anders Jorgensen, MD, PhD, Psychiatric Center Copenhagen, Mental Health Services Copenhagen, analyzed data on nucleic acid damage from oxidative stress across the psychiatric disorder diagnostic spectrum.


Research shows nucleic acid damage from oxidative stress could be a molecular mechanism leading to increased morbidity and mortality from somatic causes in adult patients with psychiatric disorders.

“The predefined hypothesis was that individuals with psychiatric disorders have increased NA-OXS levels,” the authors wrote.

Finding Studies

In the study, the investigators searched various databases from inception to November 16, 2021, while also conducting a hand search of reference lists of relevant articles. Participants in the study were adults with measurements of any marker of DNA or RNA damage from oxidative stress, and either a cross-sectional design comparing patients with any diagnosis of psychiatric disorders with a control group or a prospective intervention.

The investigators synthesized data with random-effects and multi-level meta-analyses.

Main Outcomes

The team sought main outcomes of the standardized mean differences among patients and controls in nucleic acid oxidation markers compared across different diagnostic groups.

The analyses were divided into combinations of biological matrices and nucleic acids.

Overall, there were 82 studies included in the analyses, with a total of 205 patient vs control group comparisons, as well as 10,151 patient and 10,532 control observations.

The analysis found patients with psychiatric disorders had higher NA-OXS levels compared to the control patients across matrices and molecules.

They also found pooled effect sizes ranged from moderate for urinary DNA markers (SMD , 0.44; 95% CI, 0.20-0.68; P < .001) to very large for blood cell DNA markers (SMD , 1.12; 95% CI, 0.69-1.55; P < .001).

Patients with dementias also had higher levels of NA-OXS, as did psychotic and bipolar disorders.

After conducting a sensitivity analyses excluding low-quality studies, the investigators observed the results were not materially altered.

Also, intervention studies were few and too heterogenous for meaningful meta-analysis.

“The results of this meta-analysis suggest that there is an association with increased NA-OXS levels in individuals across the psychiatric disorder diagnostic spectrum,” the authors wrote. “NA-OXS may play a role in the somatic morbidity and mortality observed among individuals with psychiatric disorders.”

The study, “Association of Oxidative Stress–Induced Nucleic Acid Damage With Psychiatric Disorders in Adults,” was published online in JAMA Psychiatry.