Midkine (MK) is a heparin-binding growth factor implicated in various biological phenomena such as development of the hippocampus and anxiety. We evaluated serum MK levels of drug-naive (n=15) and medicated (n=25) patients with schizophrenia, and age- and sex-matched normal controls (n=38). The patients showed two clusters in the levels. Four drug-naive patients (26.7%) and two medicated patients (8.0%) had abnormally high values, but no controls did, there being a significant difference in the numbers (P=0.003, Fisher's exact test). Furthermore, in other patients, the mean MK levels in drug-naive schizophrenia (0.30+/-0.10 ng/ml) were significantly (P=0.018, Fisher's protected least significant difference test) decreased than those in the controls (0.40+/-0.12 ng/ml). These suggest that there are two clusters of serum MK abnormalities in drug-naive patients with schizophrenia.