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The Neuropsychiatry of Pellagra in Early American Studies
Andrea E. Cavanna, M.D.; James W. Mitchell, M.D.; Adrian C. Williams, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:E08-E08. doi:10.1176/appi.neuropsych.12090209
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There was no conflict of interest concerning the research related to the manuscript.

Dept. of Neuropsychiatry, BSMHFT and University of Birmingham, U.K. (AEC)
Sobell Dept. of Motor Neuroscience and Movement Disorders, UCL and Institute of Neurology, London, U.K. (AEC)
Dept. of Neurology, UHB and University of Birmingham, U.K. (JWM, ACW)

Correspondence: Andrea E. Cavanna, M.D., Ph.D.; e-mail: A.Cavanna@ion.ucl.ac.uk

Copyright © 2013 by the American Psychiatric Association


To the Editor: Pellagra is a systemic disease resulting from decreased cellular niacin, clinically presenting with the diagnostic triad of dementia, diarrhea, and dermatitis (“the three Ds”). It is most commonly caused by dietary deficiency of niacin or its precursor tryptophan. In the early 20th century, pellagra was endemic in some of the southern states of America, where maize (a poor nutritional source of tryptophan and niacin) was the major food source.

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Cavanna  AE;  Williams  AC:  Neuropsychiatric symptoms in an early description of pellagra.  J Neuropsychiatry Clin Neurosci 2010; 22:451, e39
Paravicini  G:  Pellagra e morbo di Parkinson. (Pellagra and Parkinson disease)  Riv Pellagrol Ital 1912; 12:109–113
Green  BEM:  A review of 131 cases of pellagra.  South Med J 1913; 6:171–173
Singer  H:  Mental and nervous disorders associated with pellagra.  Arch Intern Med 1915; 15:121–146
Williams  AC;  Ramsden  DB:  Pellagra: A clue as to why energy failure causes diseases? Med Hypotheses 2007; 69:618–628
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The neuropsychiatry of pellagra in early American studies. J Neuropsychiatry Clin Neurosci 2013;25(4):E08.