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患有强迫症的儿童和青少年的脑脊液神经化学

Cerebrospinal fluid neurochemistry in children and adolescents with obsessive-compulsive disorder.

作者信息

Swedo S E, Leonard H L, Kruesi M J, Rettew D C, Listwak S J, Berrettini W, Stipetic M, Hamburger S, Gold P W, Potter W Z

机构信息

Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Md 20892.

出版信息

Arch Gen Psychiatry. 1992 Jan;49(1):29-36. doi: 10.1001/archpsyc.1992.01820010029004.

Abstract

Cerebrospinal fluid hormones, monoaminergic metabolites, and dynorphin A (1-8 sequence) were examined in 43 children with severe, primary obsessive-compulsive disorder. Cerebrospinal fluid levels of 5-hydroxyindoleacetic acid were positively correlated with one of eight obsessive-compulsive disorder severity ratings and three of seven measures of improvement following 5 weeks of treatment with clomipramine hydrochloride. Arginine vasopressin concentration was significantly and negatively correlated with several ratings of obsessive-compulsive disorder symptom severity, while oxytocin concentration was positively correlated with depressive symptoms. The ratio of arginine vasopressin to oxytocin was also negatively correlated with obsessive-compulsive disorder and depressive symptoms. Comorbid affective disorder was associated with decreased arginine vasopressin concentrations, while concomitant anxiety disorder was associated with increased oxytocin. Dynorphin A (1-8 sequence), homovanillic acid, corticotropin, 3-methoxy-4-hydroxyphenylglycol, and corticotropin releasing hormone were not significantly related to obsessive-compulsive disorder symptoms. These results seem to indicate that arginine vasopressin may be related to obsessive-compulsive disorder symptom severity, while 5-hydroxyindoleacetic acid might be associated with drug response.

摘要

对43名患有重度原发性强迫症的儿童的脑脊液激素、单胺能代谢产物和强啡肽A(1-8序列)进行了检测。脑脊液中5-羟吲哚乙酸水平与八项强迫症严重程度评分中的一项以及在接受盐酸氯米帕明治疗5周后的七项改善指标中的三项呈正相关。精氨酸加压素浓度与强迫症症状严重程度的多项评分呈显著负相关,而催产素浓度与抑郁症状呈正相关。精氨酸加压素与催产素的比值也与强迫症和抑郁症状呈负相关。共病情感障碍与精氨酸加压素浓度降低有关,而伴发焦虑障碍与催产素增加有关。强啡肽A(1-8序列)、高香草酸、促肾上腺皮质激素、3-甲氧基-4-羟基苯乙二醇和促肾上腺皮质激素释放激素与强迫症症状无显著相关性。这些结果似乎表明,精氨酸加压素可能与强迫症症状严重程度有关,而5-羟吲哚乙酸可能与药物反应有关。

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