Prevalence and Treatment Response of Neuropsychiatric Disorders in Mast Cell Activation Syndrome, 2025, Leonard B. Weinstock MD, FACG et al

Mij

Mij

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Highlights​

  • MCAS is a common inflammatory disease characterized by mast cell dysregulation.
  • 19 neurologic and 14 psychologic disorders were significantly increased in MCAS subjects
  • Chemical mediators, genetic predisposition, and life experiences could determine which disorders occur or worsen.

Abstract​

Background​

Neuropsychiatric disorders have been observed in mast cell activation syndrome (MCAS). MCAS is a common, yet rarely diagnosed, inflammatory, and immunologic disease characterized by mast cell dysregulation.

Methods ​

Questionnaires from 553 MCAS and 558 control subjects determined the prevalence and odds ratio of neurologic disorders (fatigue, cognitive dysfunction, fainting/near fainting, migraine-like headaches, muscle pain/tenderness/weakness, pain/numbness/tingling in extremities, restless legs syndrome, seizure-like activity, insomnia, sleep attacks, tinnitus, acoustic startle, Tourette's syndrome, resting tremor, and light/sun/pain/odors/scents/noise hypersensitivity) and psychiatric disorders (anxiety, agoraphobia, panic attacks, depression, bipolar depression, mania/hypomania, psychosis/schizophrenia, hallucinations, obsessive compulsive disorder, attention-deficit/hyperactivity disorder, anger management problems, post-traumatic stress disorder, suicidal thoughts, and eating disorders).

Results​

Among 19 neurologic disorders, female MCAS patients reported higher rates in all but 1 disorder and male MCAS patients reported higher rates in all but 2 disorders. Among 14 psychiatric disorders, female MCAS patients reported higher rates in all and male MCAS patients reported higher rates in 8 disorders. Many of the disorders with increased prevalences were statistically greater compared to corresponding controls.
In self-reported ratings for effects on health status (0=no benefit, 10=maximum benefit), mean (SD) response was 6.3 (2.5) for antihistamines, 5.6 (3.2) for low-dose naltrexone, and 5.6 (3.1) for benzodiazepines.

Conclusion​

MCAS subjects have significantly elevated odds ratios for many neuropsychiatric disorders and may see improvement of symptoms using MCAS-targeted therapies, suggesting that mast cell dysregulation affects the brain and peripheral nervous systems and contributes to neuropsychiatric symptoms. Certain mast cell mediators, specific genetic predisposition, and life experiences could determine which disorder is apt to develop or worsen.
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I am again, and forever, unclear what psychiatric even means, outside of relating to psychiatry, which is circular. By some definitions, being drunk is psychiatric. And I don't mean being alcoholic, I mean simply being drunk, as it's a change in behavior. Or having a fever.

The more I read out of psychiatry, and the more obvious it becomes that neither do they. It's more or less the run-off from the rest of medicine, even though it apparently now has its own run-off, in the form of diagnoses that are neither physical nor mental, neither psychiatric nor medical (which is absurd but whatever), neither somatic nor mental. Which happens to be mostly us. That's just great.
 
It's entirely arbitrary. It's a biological disorder that induces brain dysfunction that manifests in specific ways. Unlike the tremors and motor disturbances (and cognitive dysfunction) of Parkinson's, unlike the sensory and motor disturbances of demyelinating process, that may vary spatially and temporally, unlike the movement, swallowing/speaking dysfunction of ALS: these result in disordered eating drive, elevated or depressed mood, psychosis. But it's all biological, yet mental illness is siloed off and othered. Likely a defence mechanism by people who think they simply must be immune (hah) by virtue of their superior cognition, generally positive attitude to life etc.

I'll take the claims of "no dualism, no you're the dualist" a bit more seriously when I stop receiving weekly referrals for neuro-imaging that read: "First onset of psychosis. Exclude organic pathology."

People, I can't "exclude organic pathology". My CT (or MRI) scanner can not see the immune cells or the mitochondria. Some day soon I hope it will though, at least in proxy. Just ask "is there a tumour we could excise or hydrocephalus we could shunt?". But cut the "organic" crap — it's all organic, it's literally affecting an organ.
 
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