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Neural cell adhesion molecule (NCAM) plays an important role in neural plasticity, and its altered function has been implicated in psychiatric disorders. However, previous studies have yielded inconsistent results on cerebrospinal fluid (CSF) NCAM levels in psychiatric disorders. The aim of our study was to examine CSF NCAM levels in patients with schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD), and their possible relationship with clinical variables.The participants comprised 85 patients with schizophrenia, 57 patients with BD, 83 patients with MDD and 111 healthy controls, all matched for age, sex, and Japanese ethnicity. The CSF samples were drawn using a lumbar puncture and NCAM levels were quantified by an enzyme-linked immunosorbent assay.Analysis of covariance controlling for age and sex revealed that CSF NCAM levels were lower in all patients (p = 0.033), and in those with BD (p = 0.039), than in the controls. NCAM levels positively correlated with age in patients with BD (p < 0.01), MDD (p < 0.01), and the controls (p < 0.01). NCAM levels negatively correlated with depressive symptom scores in patients with BD (p = 0.040). In patients with schizophrenia, NCAM levels correlated negatively with negative symptom scores (p = 0.029), and correlated positively with scores for cognitive functions such as category fluency (p = 0.011) and letter fluency (p = 0.023) scores.We showed that CSF NCAM levels were lower in psychiatric patients, particularly bipolar patients than in the controls. Furthermore, we found correlations of NCAM levels with clinical symptoms in patients with BD and in those with schizophrenia, suggesting the involvement of central NCAM in the symptom formation of severe psychiatric disorders.Cerebrospinal fluid (CSF) NCAM levels were lower in psychiatric, especially bipolar patients than in healthy controls.CSF NCAM levels showed a negative correlation with depressive symptom scores in bipolar patients.CSF NCAM levels correlated negatively with negative symptom scores in patients with schizophrenia.CSF NCAM levels correlated positively with verbal fluency scores in patients with schizophrenia.