Urinary phenylacetic acid in panic disorder with and without depression

Phenylacetic acid (PAA) excretion was measured in 39 patients who met criteria for panic disorder; 9 of these also had major depression, and 30 did not. Patients with panic and depression excreted 66 +/- 23 mg/day of PAA, an amount significantly lower than in normal controls; patients with panic disorder but without depression excreted 104 +/- 23 mg/day of PAA (not significantly lower than controls). The results support previous studies indicating that PAA excretion is a marker for depressive disorder.     

苯乙酸对大鼠原代皮质神经元的毒性作用

探讨苯乙酸 (phenylacetic acid,PAA)对大鼠原代培养的皮质神经元的毒性作用及其作用机制。实验结果显示 ,PAA加入无血清 Neurobasal培养基可剂量依赖地损伤原代培养的皮质神经元 ,且干预培养的时间越长 ,神经元存活率越低。而同浓度 (1 .1× 1 0 -3mol/L)的 PAA对皮质神经元的损伤明显高于海马。原代培养的皮质神经元补充一氧化氮合成酶抑制剂 L- NAME、NMDA受体拮抗剂 MR- 80 1及 L型钙通道阻滞剂尼莫地平可显著地抵抗 PAA的毒性作用。以上实验结果提示 ,PAA可选择性地损伤皮质神经元 ,其毒性作用可能与 NO过量产生、兴奋性氨基酸的堆积及钙超载有关     

Cerebrospinal fluid levels of phenylacetic acid in mental illness: behavioral associations and response to neuroleptic treatment

Cerebrospinal fluid levels of phenylacetic acid (CCSF PAA) were obtained from normal controls and from drug-free psychiatric inpatients (schizophrenia, major depression, mania, and schizoaffective disorder). Post-treatment CCSF PAA levels were obtained from 16 patients after 4 weeks of neuroleptic treatment. Phenylacetic acid levels were higher in women and were significantly correlated with age. There were no differences in CCSF PAA levels between the various diagnostic groups and no difference between the paranoid and the nonparanoid subtypes of schizophrenia. CCSF PAA was significantly correlated with several measures of psychopathology, especially the Brief Psychiatric Rating Scale hostility/suspiciousness factor. Neuroleptic treatment did not result in significant PAA changes. These findings are discussed in light of the amphetamine-like role ascribed to phenylethylamine, the precursor of PAA.     

Urinary biopterin and neopterin excretion and pituitary-adrenal activity in psychiatric patients

The urinary excretion of biopterin and neopterin, pterin compounds related to tetrahydrobiopterin, the cofactor for the initial steps in monoamine synthesis, was serially measured in a heterogeneous group of psychiatric patients and compared to excretion in control subjects, to state of illness, and to the results of the dexamethasone suppression test. Patients with major depression had increased excretion of biopterin compared to normal subjects. There was no relationship between biopterin or neopterin excretion and postdexamethasone cortisol levels. Pterin excretion did not significantly change with improvement in mood or with conversion from nonsuppressor to suppressor status. The meaning of increased urinary biopterin is presently unclear, although its relation to hormonal state and sympathoadrenal tone deserves further study.     

Analysis and the effects of some drugs on the metabolism of phenylethylamine and phenylacetic acid

1. Phenylethylamine has been reliably measured using radioenzymatic, gas Chromatographic, mass spectromatic and gas Chromatographie — mass spectrometric methods.

2. Phenylacetic acid has been measured using gas Chromatographic and gas chromatographicmass spectrometric methods.

3. Phenylethylamine concentrations are increased primarily by phenylalanine, its amino acid precursor and by such monoamine oxidase inhibitors as L-deprenyl and pargyline.

4. Phenylethylamine administration influences other neurotransmitters such as dopamine, norepineph rine and 5-hydroxytryptamine. It also effects the tyramines and possibly tryptamine.     

Paroxetine and imipramine treatment of depressive patients in a controlled multicentre study with plasma amino acid measurements.

In a 12-week double-blind study with 36 patients with major depressive episode (DSM-III), paroxetine (Seroxat, Aropax) showed significantly quicker onset of efficacy on the Melancholia Scale, and better tolerance than imipramine. Plasma concentration analyses showed no clear concentration-efficacy correlation in either treatment group. During long-term treatment paroxetine seemed to be superior to imipramine in preventing relapse; both treatments were well tolerated. A significant correlation between baseline plasma tryptophan: large neutral amino acids ratio and final Hamilton Rating Scale for Depression (HRSD) score and a trend towards an inverse correlation between this ratio and percentage reduction in HRSD score were seen in the paroxetine group but not in the imipramine group. In line with previous studies, these results support the hypothesis that paroxetine is an effective and well tolerated antidepressant.     

Urinary excretion of 5-hydroxyindoleacetic acid--no relationship to the level in cerebrospinal fluid

Concentrations of 5-hydroxyindoleacetic acid (5-HIAA) were determined in urine and cerebrospinal fluid (CSF) by mass fragmentography. A pronounced day-to-day variation in the urinary excretion of 5-HIAA was found both in psychiatric patients and a healthy control. Lumbar punctures performed twice 3-12 weeks apart in 11 healthy controls resulted in reproducible levels of 5-HIAA in CSF (r = 0.89; P less than 0.001). The mean of three periods of daily 5-HIAA excretion was not correlated to the CSF level measured in 18 psychiatric patients (r = 0.09). Three weeks of chlorimipramine treatment significantly decreased CSF 5-HIAA levels (P less than 0.05), but not the urinary excretion of 5-HIAA. It might be concluded that measurement of urinary 5-HIAA excretion is of little value compared to CSF levels in studies of serotonin in the central nervous system.     

帕金森病认知障碍与血尿酸水平的相关性分析

目的 测定帕金森病(PD)患者血尿酸浓度,并探讨血尿酸水平与PD认知障碍的关系.方法 选择87例PD患者和81例健康对照,应用简易精神状态量表(MMSE)、韦氏智力量表(Wechsler Intelligence Scale)、韦氏记忆量表(WechslerMemory Scale)对PD患者行认知功能评定,应用统一帕金森病评定量表(UPDRS)第三部分行运动功能评定,应用Hoehn-Yahr(H-Y)分级行PD病情严重程度评定,并测定血尿酸浓度.比较PD组和对照组血尿酸水平的差异,比较PD不同病情严重程度间血尿酸浓度的差异,分析各项神经心理分测验与血尿酸的关系.结果 PD组血尿酸浓度显著低于对照组,差异有统计学意义(P＜0.05).H-Y＜3组和H-Y≥3组间浓度差异无统计学意义(P＞0.05).线性回归分析发现PD患者尿酸与各项神经心理测试无明显相关性(P＞0.05).结论 血尿酸浓度降低与PD可能有关,与PD认知障碍可能无关.     

Urinary excretion of biopterin and neopterin in psychiatric disorders

Levels of urinary neopterin and biopterin were determined in patients having a diagnosis of schizophrenia, unipolar depression, or bipolar depression. Both neopterin and biopterin levels were significantly higher in the urine of patients with unipolar depression than in the urine of the control group. Subclassification of patients into primary and secondary depression demonstrated a significant elevation of urinary biopterin in both groups, whereas urinary neopterin was elevated only in those patients with primary depression. In patients with bipolar depression, neopterin excretion was elevated, but biopterin excretion did not differ from controls. No significant differences were found in schizophrenic patients.     

Phenylethylamine and phenylacetic acid in CSF of schizophrenics and healthy controls

Summary Phenylethylamine (PEA) is an endogenous substance with amphetamine-like stimulant properties. On the basis of this ability an abnormal brain PEA metabolism has been proposed as an etiological factor in some forms of schizophrenia.In the present study 28 schizophrenic patients and 15 healthy controls were investigated. No significant difference from control values was found in PEA concentration in cerebrospinal fluid (CSF) of either untreated or neuroleptic-treated schizophrenics. However, 2 schizophrenics with highest BPRS scores had extremely high PEA concentrations. Free phenylacetic acid (PAA), the major metabolite of PEA, was significantly decreased in ummedicated but not in drug-treated schizophrenics.Because of the assumed neuromodulatory properties of PEA, it is suggested that lowered PAA concentrations and the tendency for PEA to be elevated may imply that altered central neurotransmission occurs in certain forms of schizophrenia.     

High phenylacetic acid differentiates schizoaffective from schizophrenic patients

Twenty-four hour urinary phenylacetic acid was high in 12 acutely psychotic schizoaffective patients (240.3 +/- 51.9 mg/day) and low in 16 acutely psychotic schizophrenic patients (53.6 +/- 15.1 mg/day). These results indicate a biochemical difference between these two types of acute psychoses and indicate alterations in phenylalanine metabolism.     

Prazosin, a specific alpha 1-noradrenergic receptor antagonist, has no effect on symptoms but increases autonomic arousal in schizophrenic patients

The specific alpha 1-noradrenergic antagonist, prazosin, was administered to seven schizophrenic patients in a double-blind, placebo-controlled trial. Patients showed no change in any of their psychiatric symptoms as rated by nurses on global depression and psychosis scales and by physicians on the Brief Psychiatric Rating Scale. However, they did show a significant increase in autonomic arousal as measured by changes in skin conductance. The increased autonomic arousal is probably mediated by increases in plasma norepinephrine induced by chronic prazosin treatment.     

抑郁症患者的躯体症状

目的:了解抑郁症患者的躯体症状特征。方法:采用自制调查表对符合中国精神障碍分类与诊断标准第3版抑郁发作的119例门诊及住院患者进行调查。根据汉密尔顿抑郁量表(HAMD)评分,将119例患者分为轻度、重度抑郁症两组,比较两组的一般资料及躯体症状。结果:两组的一般资料差异无显著性,而重度抑郁组躯体症状与轻度抑郁组差异显著。结论:抑郁症的躯体症状非常突出,应引起足够重视。     

Predictors of depressive symptoms at hospital discharge in patients with major depressive disorder

Abstract

Objective. Often patients with major depressive disorder (MDD) leave the hospital with continued significant symptomatology. This study sought to evaluate demographic, clinical, and psychosocial predictors of the presence of clinically significant depressive symptoms, defined as a Modified Hamilton Rating Scale for Depression score of ≥ 14, immediately following hospitalization for MDD. Methods. The study enrolled 135 patients with MDD as part of a larger clinical trial investigating the efficacy of post-hospitalization pharmacologic and psychosocial treatments for depressed inpatients. Structured clinical interview and self-report data were available from 126 patients at hospital admission and discharge. Results. Despite the significant decreases in depressive symptoms over the course of hospitalization, 91 (72%) displayed clinically significant depressive symptoms at discharge. Multivariate logistic regression analysis revealed that female sex, earlier age of onset, and poorer social adjustment were unique predictors of symptom outcome. Conclusions. Results suggest that a large proportion of patients leave the hospital with continued significant symptomatology, and the presence of such symptoms following hospitalization for MDD is likely to be explained by a combination of factors.     

抑郁症患者家庭功能调查

目的:探讨抑郁症患者的家庭功能及其相关因素。方法:选择94例抑郁症患者,应用中文版家庭亲密度与适应性量表第2版(FACESⅡCV),从亲密度和适应性2个维度评定抑郁症患者的家庭功能,并应用多元回归分析其相关因素。结果:与正常对照组相比,治疗前家庭亲密度与适应性显著较差,治疗后有显著改善。其相关因素有性别、文化程度、成长地、病程及是否首发等。结论:抑郁症患者的家庭亲密度与适应性存在缺陷。     

抑郁症患者应付方式特点研究

目的：了解抑郁症患者的应付方式特点及对抑郁症状作用。方法：对184例患者,平分为研究组（药物治疗＋应付方式指导）和对照组（单纯药物治疗）,治疗2个月。于治疗前和治疗后分别采用应付方式问卷和汉密尔顿抑郁量表（HAMD）评定应付方式与疾病的严重程度和疗效。结果：抑郁症患者所选择的应付方式主要是自责、退避和幻想,而相对较少使用解决问题、合理化和求助;抑郁症状的严重程度与应付方式各因子除合理化相关性不明显外,与其余因子均存在显著相关。治疗后研究组与对照组应付方式各因子比较除合理化因子外差异均有显著性（P〈0．01-0．05）。结论：应付方式影响抑郁症状,通过应付方式指导可以提高抑郁症治疗效果。