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Correlation of individual symptoms and other clinical variables with cerebrospinal fluid amine metabolites and tryptophan in depression

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Summary

Cerebrospinal fluid 5-hydroxyindoleacetic acid (5HIAA), homovanillic acid (HVA), and tryptophan in both CSF and plasma were measured in a carefully selected group of 33 depressed women. Strict and explicit inclusion and exclusion criteria were used, and CSF was taken under controlled circumstances. Seventeen operationally defined and uniformly rated psychiatric symptoms as well as global depression severity and 12 clinical background variables were correlated with the four biochemical parameters, using multivariate regression analysis based on Spearman's rank correlation coefficient according to the nature of the data.

Global depression severity did not correlate with any of the biochemical variables; there were, however, significant correlations between CSF 5HIAA and anxiety, insomnia, and suicide on the one hand, and between CSF HVA and motor symptoms and paranoidity on the other hand. Background variables showed only a few-and much weaker-correlations. It was concluded that central monoamine metabolism does affect some particular psychiatric symptoms but is not parallel with the complex clinical construct of the depressive disease. Further studies using isolated psychopathological symptoms instead of nosological categories are suggested in clinical neurochemistry.

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Abbreviations

Dysthymia:

depressed mood, despair, dejection, hopelessness if congruently reflected in subjective experience and behavior

Anxiety:

fear, tension, restlessness, worrying, ‘nervousness’ if accompanied by congruent vegetative signs or stereotypies

Suicide:

intention, planning, preparation or attempt, except if obviously only a provocative statement

Anhedonia:

loss of interest in pleasure-giving and -receiving (including sexual libido), if it has been a painful change of affect

Insufficiency:

feeling of uselessness, inadequacy, with subjective loss of ability to appropriately think, act, and decide

Fatigability:

loss of energy, helplessness, tiredness which demands extra repose which however does not bring about restoration

Anorexia:

only if real weight loss (at least 2.5 kg) is present

Insomnia:

only if total sleep time has been reduced by at least 3 h and it causes important subjective trouble

Somatization:

all subjectively relevant physical complaints that are not readily explained by medical disease

Obsession-Compulsion:

thoughts and acts the patient feels irresistibly compelled to perform while considering them unpleasant and irrational

Hypochondria:

pervasive fear of or presumption about the presence of a severe or life- threatening disease without its actual signs

Agitation:

permanent motor restlessness that interferes with relaxation and orderly activities

Retardation:

reduction and slowing down of voluntary and expressive movements without causative medical or CNS disease

Perseveration:

repetition of the same word, phrase, or topic if hampers reasonable communication and unexplained by aphasia

Paranoia:

uncontrollable feelings of being intentionally wronged, injured, or pursued by real people, if disproportionate to reality or if it motivates acts causing greater disadvantage that that presumably being submitted to

Depressive thoughts:

permanent and not easily controlled feelings about guilt, sin, worthlessness, impoverishment, damnation

Negation:

lack of insight, no acceptance of the possibility of an illness or even of a change when confronted with the present symptoms

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Authors and Affiliations

  1. The Regional Neuropsychiatric Institute, H-4321, Nagykallo, Hungary

    C. M. Banki M.D.

  2. Department of Psychiatry, Semmelweis University School of Medicine, H-1083, Budapest, Hungary

    G. Molnar

  3. Computer Technique Section, Bánki Donát High School for Technology and Engineering, H-1428, Budapest, Hungary

    I. Fekete

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  1. C. M. Banki M.D.
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  2. G. Molnar
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  3. I. Fekete
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Banki, C.M., Molnar, G. & Fekete, I. Correlation of individual symptoms and other clinical variables with cerebrospinal fluid amine metabolites and tryptophan in depression. Arch. F. Psychiatr. U. Z. Neur. 229, 345–353 (1981). https://doi.org/10.1007/BF01833162

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  • DOI: https://doi.org/10.1007/BF01833162

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