Neurochemical variables in subjects with adjustment disorder after suicide attempts.

The investigation of biological correlates of suicidal behavior is important for identifying high-risk subjects. The objective of this study was to examine the neurochemical variables' platelet MAO activity and urinary MHPG, 5HIAA and HVA, the main metabolites of noradrenaline, serotonin and dopamine, neurotransmitters that are considered to be involved in the pathophysiology of suicidal behavior, as well as plasma cortisol, in a group of subjects with adjustment disorder after a suicide attempt. Fifty-three patients, 42 females and 11 males, were included in the study and were compared to a group of 50 healthy controls, 25 females and 25 males. Platelet MAO activity was found to be significantly lower in both male and female patients compared to controls of the same sex (P < 0. 001 for both comparisons). 5HIAA and HVA were not different between patients and controls, but MHPG was significantly higher in the patients group (P = 0.008). Moreover, plasma levels of cortisol were significantly higher in the patients compared to the controls (P < 0. 001). Our results confirm the hypothesis of low platelet MAO activity as a biological characteristic of patients who attempt suicide. They also point to a possible parallel activation of the noradrenergic system.

Platelet MAO activity in patients with dysthymic disorder.

The aim of the present study was to examine possible associations between platelet monoamine oxidase (MAO) activity and primary dysthymic disorder. For that purpose we estimated the enzyme activity in 58 patients (15 males and 43 females) selected according to DSM-III-R criteria and in 61 healthy controls (30 males and 31 females). Platelet MAO activities were found significantly lower in the female patients compared to female controls. Moreover, the enzyme activities were found to be even lower in the female patients who had attempted suicide. These differences did not exist in the male population. We could not find any associations of MAO activity to the age of the patients, the age of onset, the duration of dysthymia, or HAM-D and SCL-90R scores. Our findings are consistent with the hypothesis that platelet MAO activity is a trait-dependent indicator of vulnerability to dysthymic disorder and suicidality in our female population.

Levels of anxiety, depression and denial in patients with myocardial infarction.

In this study we investigated 1) the changes in anxiety, depression and denial from admission to discharge in patients admitted to the intensive care unit following an acute myocardial infarction and 2) the effect of smoking habits, time lapsed from the appearance of symptoms to seeking help behavior, presence of a person that motivated the patient to seek help, previous myocardial infarction (MI) and family history of MI, on these changes. The results indicated that 1) the levels of both anxiety and depression increased from admission to discharge, while denial decreased; 2) positive family history of MI was associated with lower difference of denial between admission and discharge.

Platelet monoamine oxidase in attempted suicide. Relations to sex, psychiatric diagnosis, mode of attempt, and previous attempts.

Platelet monoamine oxidase (MAO) activities were assessed in 82 patients, 57 females and 25 males, who were admitted to the medical ward of a general hospital after a suicide attempt. The enzyme activities were compared to the activities of healthy subjects, 35 females and 26 males. In addition, MAO activities were analyzed in relation to sex, psychiatric diagnosis, mode of attempt, drugs ingested, and previous attempts. Compared to normal controls, only female patients showed lower MAO activities. In the male population, lower activities were found in the subgroup of patients who had made previous attempts. In relation to diagnosis, analysis performed in the female population revealed lower MAO activities in the dysthymic and personality disorder, and not in the adjustment or major affective disorder subgroups. MAO activities were not related to the violent mode of attempt, the type of medication used, or the score in the Beck Suicidal Intent scale. The finding of low platelet MAO activities in dysthymic disorder, indicates the need for further studies of biological variables in this underdiagnosed and undertreated diagnostic group.

Clonidine trial in tardive dyskinesia. Therapeutic response, MHPG, and plasma DBH.

The a2-adrenergic receptor agonist clonidine has a beneficial effect on tardive dyskinetic symptomatology (TDS), in the pathophysiology of which the involvement of noradrenergic mechanisms, among others, has been proposed. The authors investigated possible relationships between the therapeutic efficacy of clonidine in patients with tardive dyskinesia (TD) and concentrations in urine and plasma of the main noradrenaline (NA) metabolite methoxyhydroxyphenylglycol (MHPG), and of the NA biosynthetic enzyme dopamine-b-hydroxylase (DBH) in plasma. Clonidine was administered to twelve chronic schizophrenic patients with TDS in a double-blind, cross-over, single-dose trial. MHPG was measured in urine samples collected before and after administration. MHPG and DBH were also measured in plasma of blood samples taken three hours after administration. Ten patients then received clonidine in addition to neuroleptics for a period of two weeks. Clonidine caused significant amelioration in TDS both in the single-dose and the two-week trials. The degree of amelioration was, however, not correlated with the MHPG or DBH baseline values, or with the differences between placebo and drug in the single-dose trial.

Neurochemical studies on tardive dyskinesia. I. Urinary homovanillic acid and plasma prolactin.

Forty-two schizophrenic patients under chronic neuroleptic treatment (11-24 years) were studied, 20 without and 22 with tardive dyskinetic symptomatology. Blood and urine samples were collected on 3 consecutive days. Plasma prolactin (PRL) and urinary homovanillic acid (HVA) values were higher in both tardive dyskinetic and nontardive dyskinetic groups, compared to normals. The increased PRL and HVA values were not related to tardive dyskinesia but to the actual neuroleptic dose. The subgroup of patients with actual dose under 900 chlorpromazine equivalents had normal PRL values and increased HVA at low significance level compared to normals, while the subgroup with doses over 900 equivalents had highly significant (p less than 0.001) increased PRL and HVA values. Thus, the actual neuroleptic dose determines plasma PRL and urinary HVA excretion in patients chronically treated with neuroleptics.

Neurochemical studies on tardive dyskinesia. II. Urinary methoxyhydroxyphenylglycol and plasma dopamine-beta-hydroxylase.

The noradrenergic correlates 3-methoxy-4-hydroxy-phenylglycol (MHPG) in urine and dopamine-beta-hydroxylase (DBH) in plasma were estimated on 3 consecutive days in chronic schizophrenic patients under neuroleptic treatment, 20 without and 22 with tardive dyskinetic symptomatology. Compared to normals, no differences in DBH activities were found, but MHPG excretion was higher in both patient groups. Dichotomy of DBH and MHPG values according to their medians for the 42 patients revealed a higher incidence of low DBH activities and low MHPG excretion in the tardive dyskinesia group, while there were no differences in relation to low or high actual neuroleptic dose.