De Bellis M D, Lefter L, Trickett P K, Putnam F W
Department of Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213-2593.
J Am Acad Child Adolesc Psychiatry. 1994 Mar-Apr;33(3):320-7. doi: 10.1097/00004583-199403000-00004.
The objective of this study was to examine urinary catecholamine excretion in a self-selected sample of sexually abused and demographically matched control girls recruited from a prospective, longitudinal study.
Twenty-four--hour urinary catecholamine and metabolite concentrations of epinephrine, norepinephrine, dopamine, 3-methoxy-4-hydroxyphenylglycol, metanephrine, normetanephrine, vanillylmandelic acid, 3,4-dihydroxyphenylacetic acid, and homovanillic acid were measured in 12 sexually abused and 9 control girls, aged 8 to 15 years. Psychiatric profiles also were obtained.
The abused subjects excreted significantly greater amounts of metanephrine, vanillylmandelic acid, homovanillic acid, and total catecholamine synthesis as measured by the sum of epinephrine, norepinephrine, dopamine, and their metabolites compared to values from control subjects. When the means of all significant biochemical measures were adjusted by the covariate effect of height, only homovanillic acid and group interaction remained significant. There were positive trends toward significantly higher urinary excretion of metanephrine, vanillylmandelic acid, and total catecholamine synthesis. Sexually abused girls also had a greater incidence of suicidal ideation, suicide attempts, and dysthymia than control girls.
These findings support the idea that sexually abused girls show evidence of higher catecholamine functional activity compared with controls. The clinical significance of these findings in their similarity to the psychobiology of both post-traumatic stress disorder and major depressive disorder. Results from this pilot study may be of value in understanding the mechanisms of depressive and anxiety disorders and in the clinical treatment of maltreated children.
本研究的目的是在一项前瞻性纵向研究招募的性虐待女孩及其人口统计学匹配的对照女孩的自我选择样本中，检测尿儿茶酚胺排泄情况。
测量了12名年龄在8至15岁的性虐待女孩和9名对照女孩24小时尿中肾上腺素、去甲肾上腺素、多巴胺、3-甲氧基-4-羟基苯乙二醇、间甲肾上腺素、去甲间肾上腺素、香草扁桃酸、3,4-二羟基苯乙酸和高香草酸的儿茶酚胺及代谢物浓度。还获取了精神科概况。
与对照受试者的值相比，受虐待受试者排泄的间甲肾上腺素、香草扁桃酸、高香草酸以及通过肾上腺素、去甲肾上腺素、多巴胺及其代谢物总和测量的总儿茶酚胺合成量显著更高。当所有显著生化指标的均值通过身高的协变量效应进行调整时，只有高香草酸和组间交互作用仍具有显著性。间甲肾上腺素、香草扁桃酸和总儿茶酚胺合成的尿排泄量有显著升高的正向趋势。性虐待女孩的自杀意念、自杀未遂和心境恶劣的发生率也高于对照女孩。
这些发现支持这样一种观点，即与对照组相比，性虐待女孩表现出儿茶酚胺功能活性更高的证据。这些发现的临床意义在于它们与创伤后应激障碍和重度抑郁症的心理生物学相似。这项初步研究的结果可能对理解抑郁和焦虑障碍的机制以及受虐待儿童的临床治疗有价值。
