Oades R D, Röpcke B, Eggers C
Clinic for Child and Adolescent Psychiatry, University of Essen, Federal Republic of Germany.
J Neural Transm Gen Sect. 1994;96(2):143-59. doi: 10.1007/BF01277936.
Positive psychotic symptoms are reported to be associated with high, negative symptoms with low dopamine (DA) activity and serotonin (5HT) activity may be altered in obsessive-compulsive disorder (OCD). We analysed 24 h urine samples in these patient groups and in healthy controls for supportive evidence. Young unmedicated OCD subjects excreted more adrenaline (AD) and homovanillic acid (HVA) and showed a higher HVA/MHPG ratio and metabolic rate than healthy controls. Independent of general metabolic rate they showed higher HVA concentrations which suggests that the relative activity of catecholamine systems in OCD (HVA/MHPG) is due more to high DA than to low noradrenergic (NA) activity. Concentrations of 5HT were also high in OCD patients. In psychotic patients low levels of DA, HVA, NA and MHPG probably resulted from neuroleptic medication. Patients diagnosed with paranoid psychosis showed higher DA utilization than controls and those with few paranoid symptoms showed high 5HT utilization. These results support studies suggesting that paranoid psychosis is associated more with increased DA activity (discussed in the context of neuroleptic reactivity), that non-paranoid forms are associated more with increased 5HT activity and that OCD patients are unusually aroused with high levels of Ad, 5HT and HVA.
据报道，阳性精神病性症状与多巴胺（DA）活性高有关，阴性症状与多巴胺活性低有关，而强迫症（OCD）患者的血清素（5HT）活性可能会发生改变。我们分析了这些患者组和健康对照者的24小时尿液样本，以寻找支持性证据。未接受药物治疗的年轻强迫症受试者排泄的肾上腺素（AD）和高香草酸（HVA）更多，且与健康对照者相比，其HVA/MHPG比值和代谢率更高。独立于一般代谢率之外，他们的HVA浓度更高，这表明强迫症患者儿茶酚胺系统的相对活性（HVA/MHPG）更多是由于多巴胺水平高，而非去甲肾上腺素能（NA）活性低。强迫症患者的5HT浓度也很高。精神病患者多巴胺、高香草酸、去甲肾上腺素和3-甲氧基-4-羟基苯乙二醇水平低可能是由于服用了抗精神病药物。被诊断为偏执型精神病的患者比对照组的多巴胺利用率更高，而偏执症状较少的患者5HT利用率较高。这些结果支持了一些研究，这些研究表明偏执型精神病更多地与多巴胺活性增加有关（在抗精神病药物反应性的背景下进行讨论），非偏执型形式更多地与5HT活性增加有关，且强迫症患者因肾上腺素、5HT和高香草酸水平高而异常兴奋。
