Akarsu Süleyman, Bolu Abdullah, Aydemir Emre, Zincir Selma Bozkurt, Kurt Yasemin Gülcan, Zincir Serkan, Erdem Murat, Uzun Özcan
Department of Psychiatry, Freelance Physician, Hatay, Turkey.
Department of Psychiatry, Gülhane Education and Research Hospital, Ankara, Turkey.
Psychiatry Investig. 2018 May;15(5):514-519. doi: 10.30773/pi.2016.12.31. Epub 2018 Apr 20.
Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4- 5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study.
Eighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC.
There were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group.
Significant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.
双相情感障碍（BD）是一种慢性情绪障碍，其特征为反复发作，终生患病率为0.4 - 5.5%。BD的神经化学机制尚未完全明确。神经元中的氧化应激会导致与神经元膜和细胞内酶相关的蛋白质发生脂质过氧化，这可能会导致神经递质再摄取和酶活性出现功能障碍。这些病理过程被认为发生在BD中与情感功能和情绪相关的脑区。本研究调查了躁狂发作次数与总氧化 - 抗氧化能力之间的关系。
82例因躁狂症状住院且无抑郁发作的BD患者纳入本研究。82例患者中，30例为首次躁狂发作，另外52例有两次或更多次躁狂发作。对照组包括45名社会人口统计学特征匹配的健康个体。对参与者进行血清总抗氧化能力（TAC）和总氧化能力（TOC）测量。通过TOC/TAC计算氧化应激指数（OSI）。
首次发作躁狂的BD患者与发作次数多于一次的BD患者的OSI评分无显著差异。然而，两组的OSI评分均显著高于对照组。首次发作躁狂的BD患者的TOC水平显著高于发作次数多于一次的BD患者和健康对照组。首次发作躁狂的BD患者与发作次数多于一次的BD患者的TAC水平无显著差异。两组的TAC水平均显著高于对照组。
本研究观察到氧化应激指标有显著变化，证实了先前的研究。氧化剂水平升高与疾病严重程度增加有关，而非与躁狂发作次数有关。需要进行系统研究，包括对该疾病各个阶段的研究，以便利用表明氧化参数恶化的研究结果。
