Davis J M, Koslow S H, Gibbons R D, Maas J W, Bowden C L, Casper R, Hanin I, Javaid J I, Chang S S, Stokes P E
Illinois State Psychiatric Institute, Chicago.
Arch Gen Psychiatry. 1988 Aug;45(8):705-17. doi: 10.1001/archpsyc.1988.01800320015002.
The National Institute of Mental Health-Clinical Research Branch Collaborative Study investigated 132 drug-free, severely depressed patients and 80 healthy controls. Forty-five percent of the depressed patients excreted markedly elevated levels of urinary epinephrine (E) and metanephrine (MET), while only 5% of healthy controls did so. Using gaussian mixture distributions, we identified two subgroups of depressed patients: one excreting normal levels and the other excreting high levels of urinary E, MET, norepinephrine, and normetanephrine. Cerebrospinal fluid homovanillic acid levels were low in a subgroup of depressed patients. When analyzed by subgroup, the elevated E + MET group had markedly lower cerebrospinal fluid homovanillic acid levels than controls, whereas depressed patients with normal catecholamine levels did not. Since it has been postulated that there are two subgroups of depressed patients, those with low 3-methoxy-4-hydroxyphenylglycol (MHPG) levels and normal 5-hydroxyindoleacetic acid (5-HIAA) levels and those with normal MHPG levels and low 5-HIAA levels, several analyses were performed to see if such a group could be identified. Our analysis failed to find evidence of a subgroup of depressives with low MHPG and normal 5-HIAA levels or normal MHPG and low 5-HIAA levels.
美国国立精神卫生研究所临床研究分部协作研究调查了132名未服用药物的重度抑郁症患者和80名健康对照者。45%的抑郁症患者尿肾上腺素（E）和变肾上腺素（MET）排泄水平显著升高，而健康对照者中只有5%如此。利用高斯混合分布，我们将抑郁症患者分为两个亚组：一组排泄正常水平的尿E、MET、去甲肾上腺素和甲氧基去甲肾上腺素，另一组排泄高水平的这些物质。在一组抑郁症患者中，脑脊液高香草酸水平较低。按亚组分析时，E + MET升高组的脑脊液高香草酸水平明显低于对照组，而儿茶酚胺水平正常的抑郁症患者则不然。由于推测抑郁症患者有两个亚组，即3-甲氧基-4-羟基苯乙二醇（MHPG）水平低且5-羟吲哚乙酸（5-HIAA）水平正常的患者，以及MHPG水平正常且5-HIAA水平低的患者，因此进行了多项分析，以确定是否能识别出这样一组患者。我们的分析未能找到证据表明存在MHPG水平低且5-HIAA水平正常或MHPG水平正常且5-HIAA水平低的抑郁症亚组。
