Maes M, Maes L, Schotte C, Vandewoude M, Martin M, D'Hondt P, Blockx P, Scharpé S, Cosyns P
Dept. of Biological Psychiatry, University Hospital of Antwerp, Edegem, Belgium.
Psychiatry Res. 1990 Oct;34(1):59-75. doi: 10.1016/0165-1781(90)90058-d.
The hypothalamic-pituitary-adrenal (HPA) axis, the hypothalamic-pituitary-thyroid (HPT) axis, and the availability of L-tryptophan (L-TRP) to the brain were studied in their relationships to (1) 14 depressive symptoms measured by the Structured Clinical Interview for DSM-III-R--Patient Version (SCID) and (2) the cluster-analytically generated vital/nonvital classes. The following biological parameters were measured in 100 depressed females: free thyroxine (FT4), baseline thyroid stimulating hormone (TSH), predexamethasone and postdexamethasone cortisol and adrenocorticotropic hormone (ACTH) values, the circulating levels of total L-TRP, and the L-TRP/sum of competing amino acids ratio. We found that the psychopathological correlates of disorders in the HPA/HPT axis and of a decreased availability of L-TRP were vital symptoms, i.e., distinct quality of mood, nonreactivity, early morning awakening, anorexia-weight loss, and psychomotor disorders. There was no significant relationship between those biological markers and the nonvital symptoms of the SCID inventory for depressive symptoms. However, we did not validate our SCID clustering in vital and nonvital classes by qualitative differences in the biological variables. It was concluded that our nonvital/vital clusters should be regarded as continuous categories with regard to the biological markers studied; these clusters constitute relevant stages in the continuum of progressing biological dysfunction.
对下丘脑 - 垂体 - 肾上腺（HPA）轴、下丘脑 - 垂体 - 甲状腺（HPT）轴以及大脑中L - 色氨酸（L - TRP）的可利用性进行了研究，以探讨它们与以下两方面的关系：（1）通过《精神疾病诊断与统计手册第三版修订本患者版结构化临床访谈》（SCID）测量的14种抑郁症状；（2）通过聚类分析得出的重要/非重要类别。对100名抑郁女性测量了以下生物学参数：游离甲状腺素（FT4）、基础促甲状腺激素（TSH）、地塞米松给药前和给药后皮质醇及促肾上腺皮质激素（ACTH）值、总L - TRP的循环水平以及L - TRP与竞争性氨基酸总和的比值。我们发现，HPA/HPT轴紊乱以及L - TRP可利用性降低的心理病理学相关因素是重要症状，即情绪的独特性质、无反应性、早醒、厌食 - 体重减轻和精神运动障碍。这些生物学标志物与SCID抑郁症状量表中的非重要症状之间没有显著关系。然而，我们并未通过生物学变量的质性差异来验证我们在重要和非重要类别中对SCID的聚类。得出的结论是，就所研究的生物学标志物而言，我们的非重要/重要类别应被视为连续的类别；这些类别构成了生物功能障碍进展连续体中的相关阶段。
