Gross G, Huber G, Klosterkötter J, Rao M L, Linz M
Psychiatrische Klinik und Poliklinik, Universität Bonn.
Fortschr Neurol Psychiatr. 1990 Apr;58(4):154-60. doi: 10.1055/s-2007-1001179.
The dynamics of course, i.e., the marked psychopathological fluctuation in acute phases of schizophrenic and other idiopathic psychoses was little considered up to now in investigations referred to correlating clinical and neurochemical findings. Therefore, we selected subgroups of patients, classified as inactive or slight, moderate or severe process-active according to the operational defined actual psychopathological syndrome (Gross et al. 1988, Klosterkötter et al. 1989) at the time of taking of blood samples. We demonstrated in previous studies that the fluctuation and/or sudden development (minutes, hours, up to six days at the latest) of schizophrenic first rank symptoms and certain basic symptoms may reflect also an instability and process-activity of underlying neurochemical changes. In this study we have measured the concentrations of dopamine, noradrenaline, adrenaline, 5-HT, TSH, prolactin, HGH, melatonin, cortisol, T 3, T 4 and 28 amino acids in blood samples (examined 8 times within 24 hours) from 48 schizophrenic patients, divided in 4 subgroups (each 12 cases) with severe, moderate, slight or lacking process-activity, from 20 patients with (inactive or only slight active) depressive phases of affective psychoses and from normal controls. Marked process-active schizophrenics showed significantly higher levels of dopamine, noradrenaline and 5-HT, and significantly lower levels of TSH, compared to healthy controls and process-inactive schizophrenics with pure deficiency syndromes, that reveal a relative hypo-activity of catecholaminergic and presumably also of serotoninergic systems. In the subgroup of depressions were found decreased concentrations of noradrenaline, 5-HT, adrenaline and melatonin when compared to marked process-active schizophrenics.(ABSTRACT TRUNCATED AT 250 WORDS)
当然,在以往将临床与神经化学研究结果进行关联的调查中,对于精神分裂症及其他特发性精神病急性期显著的精神病理波动,也就是病程的动态变化,几乎没有得到多少关注。因此,我们根据采血时按操作定义的实际精神病理综合征(格罗斯等人,1988年;克洛斯特克特等人,1989年),将患者分为不活跃或轻度、中度或重度病程活跃的亚组。我们在先前的研究中表明,精神分裂症一级症状和某些基本症状的波动和/或突然出现(最短几分钟,最长数小时,最晚六天)也可能反映出潜在神经化学变化的不稳定性和病程活动性。在本研究中,我们测量了48例精神分裂症患者、20例患有情感性精神病抑郁期(不活跃或仅轻度活跃)的患者以及正常对照组血液样本(24小时内检测8次)中多巴胺、去甲肾上腺素、肾上腺素、5-羟色胺、促甲状腺激素、催乳素、生长激素、褪黑素、皮质醇、T3、T4和28种氨基酸的浓度。与健康对照组和具有单纯缺陷综合征的病程不活跃的精神分裂症患者相比,显著病程活跃的精神分裂症患者的多巴胺、去甲肾上腺素和5-羟色胺水平显著更高,促甲状腺激素水平显著更低,这表明儿茶酚胺能系统以及可能还有5-羟色胺能系统相对活性较低。与显著病程活跃的精神分裂症患者相比,抑郁症亚组中去甲肾上腺素、5-羟色胺、肾上腺素和褪黑素的浓度降低。(摘要截选至250字)