Journal of Affective Disorders
Volume 74, Issue 2 , Pages 185-189, April 2003

Lifetime burden of mood swings and activation of brain norepinephrine turnover in patients with treatment-refractory depressive illness

  • Anna Ehnvall

      Affiliations

    • Research and Developmental Unit, FoU, Varberg Hospital, SE-432 81 Varberg, Sweden
    • Department of Psychiatry, Institute of Clinical Neuroscience, Göteborg University, Gothenburg, Sweden
    • Corresponding Author InformationCorresponding author. Tel.: +46-340-481-897; fax: +46-340-833-21
    • ,
  • Magnus Sjögren

      Affiliations

    • Department of Psychiatry, Institute of Clinical Neuroscience, Göteborg University, Gothenburg, Sweden
    • ,
  • Olof C.G. Zachrisson

      Affiliations

    • Department of Psychiatry, Institute of Clinical Neuroscience, Göteborg University, Gothenburg, Sweden
    • ,
  • Hans Ågren

      Affiliations

    • Karolinska Institutet, NEUROTEC, Division of Psychiatry, Huddinge Hospital, SE-141 86 Stockholm, Sweden

Received 1 December 2000; received in revised form 8 December 2001; accepted 19 December 2001.

Abstract 

Background: We tested if duration and intensity of episodes in treatment-resistant affectively ill patients were related to cerebrospinal fluid (CSF) concentrations of monoamine metabolites. Method: In retrospective life charts were recorded every previous episode of 37 patients with severe treatment-refractory affective disorders. ‘Accumulated burden of mood swings’ (ABMS, sum of each episode length×episode depth) was used to estimate the accumulated illness burden. Homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were analyzed in CSF of all patients and compared with 27 healthy controls. Data were analyzed using multiple regression analysis. Results: CSF MHPG contributed strongly significant and positively to the ABMS. Limitations: The retrospective nature of the study. Conclusion: CSF concentrations of MHPG is positively related to ABMS over life. Thus, a specific involvement of norepinephrine in the long-term burden of affective illness is a likely reality.

Keywords:  Depression, Treatment-refractory affective disorder, Life charting, monoamines, Cerebrospinal fluid, Lifetime burden of depression

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PII: S0165-0327(02)00011-3

doi:10.1016/S0165-0327(02)00011-3

Journal of Affective Disorders
Volume 74, Issue 2 , Pages 185-189, April 2003

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