Oliva Francesco, Coppola Maurizio, Mondola Raffaella, Ascheri Daniele, Cuniberti Francesco, Nibbio Gabriele, Picci Rocco Luigi
Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
Addiction Department, Azienda Sanitaria Locale CN2, Alba, CN, Italy.
BMC Psychiatry. 2017 May 12;17(1):181. doi: 10.1186/s12888-017-1342-y.
Blood homocysteine concentration (BHC) is higher in patients with alcohol use disorder (AUD). Previous studies have found a relationship between depressive symptoms severity and BHC in AUD patients and recently some authors have found high BHC among patients with bipolar disorder, both during manic and depressive episodes and in euthymic state. However, BHC in patients with mixed mood episode has not yet been investigated. The aim of this study was to evaluate the BHC of patients with AUD and mixed mood episode.
A sample of AUD outpatients was assessed by Mini-International Neuropsychiatric Interview (MINI Plus): those with a DSM-IV-TR mood disorder with mixed features were included in the MIXED group (n = 45), whereas those without mood episode were gathered in the NO MOOD group (n = 23). Two subgroups, MIXMANIA and MIXDEPRESSION, were formed according to the prevalence of manic or depressive symptoms, assessed by Young Mania Rating Scale (YMRS), and Hamilton Rating Scale for Depression (HDRS). The Alcohol Use Disorder Identification Test (AUDIT) was used to appraise the AUD. BHC was determined by High-Performance Liquid Chromatography.
The MIXED group showed greater severity of both depressive (26.35 ± 9.96 vs. 4.77 ± 0.92; p < 0.001) and manic (22.35 ± 3.30 vs. 6.14 ± 1.12; p < 0.001) symptoms, and higher BHC (28.80 ± 11.47 vs. 10.83 ± 2.81; p < 0.001), than the NO MOOD group. BHC was strongly correlated to the HDRS, YMRS and AUDIT scores, just as HDRS was to YMRS, and AUDIT was to both HDRS and YMRS, in the MIXED group only (p < 0.001). The MIXDEPRESSION subgroup showed higher BHC than the MIXMANIA subgroup (Mdn = 42.96, IQR = 10.44 vs. Mdn = 19.77, IQR = 5.93; p < 0.001). A linear regression model conducted on the MIXED group found a significant predictive value for BHC of both HDRS (β = 0.560, t = 2.43, p = 0.026) and AUDIT (β = 0.348, t = 2.17, p = 0.044).
Depressive symptoms seem to be mainly implicated in the BHC elevation among patients with both mixed features mood disorder and AUD.
酒精使用障碍（AUD）患者的血液同型半胱氨酸浓度（BHC）较高。先前的研究发现AUD患者的抑郁症状严重程度与BHC之间存在关联，最近一些作者发现双相情感障碍患者在躁狂发作、抑郁发作及心境正常状态下均存在高BHC。然而，混合情绪发作患者的BHC尚未得到研究。本研究的目的是评估AUD合并混合情绪发作患者的BHC。
采用迷你国际神经精神访谈量表（MINI Plus）对AUD门诊患者进行评估：符合DSM-IV-TR混合特征心境障碍的患者纳入混合组（n = 45），无情绪发作的患者纳入无情绪组（n = 23）。根据躁狂或抑郁症状的发生率，通过杨氏躁狂评定量表（YMRS）和汉密尔顿抑郁评定量表（HDRS）形成两个亚组，即混合躁狂组和混合抑郁组。采用酒精使用障碍识别测试（AUDIT）评估AUD。通过高效液相色谱法测定BHC。
混合组的抑郁症状（26.35 ± 9.96 vs. 4.77 ± 0.92；p < 0.001）和躁狂症状（22.35 ± 3.30 vs. 6.14 ± 1.12；p < 0.001）均比无情绪组严重，BHC也更高（28.80 ± 11.47 vs. 10.83 ± 2.81；p < 0.001）。仅在混合组中，BHC与HDRS、YMRS和AUDIT评分呈强相关，同样HDRS与YMRS、AUDIT与HDRS和YMRS也呈强相关（p < 0.001）。混合抑郁亚组的BHC高于混合躁狂亚组（中位数 = 42.96，四分位数间距 = 10.44 vs. 中位数 = 19.77，四分位数间距 = 5.93；p < 0.001）。对混合组进行的线性回归模型发现，HDRS（β = 0.560，t = 2.43，p = 0.026）和AUDIT（β = 0.348，t = 2.17，p = 0.044）对BHC均有显著预测价值。
在既有混合特征心境障碍又有AUD的患者中，抑郁症状似乎主要与BHC升高有关。
