Pitchot W, Hansenne M, Moreno A G, Ansseau M
Psychiatric Unit, Centre Hospitalier, Universitaire du Sart Tilman, Liège, Belgium.
J Psychiatry Neurosci. 1996 Nov;21(5):343-5.
Several lines of evidence suggest that dopamine plays a role in the pathophysiology of obsessive-compulsive disorder (OCD). Indeed, some trials have shown the efficacy of neuroleptic addition in the treatment of OCD patients. In this study, we assessed the growth hormone (GH) response to 0.5 mg apomorphine(sc) in 8 drug-free inpatients (6 male, 2 female; mean age +/- SD = 34.7 +/- 12.6) meeting DSM-III-R criteria for OCD without major depression and compared their responses with those of 8 healthy male volunteers (mean age = 27.1 +/- 8.5). The groups did not differ in their mean GH peak response: 12.4 +/- 9.7 ng/mL in OCD patients versus 21.1 +/- 14.2 ng/mL in normal controls (F = 0.9, df1, 14, P = 0.37). These results do not support the hypothesis of dopaminergic overactivity in OCD. In fact, the completely blunted GH response to apomorphine in 2 OCD patients suggests the biological heterogeneity of OCD. Some dopaminergic disturbances could be observed in patients with comorbid diagnoses or patients unresponsive to serotonin reuptake inhibitors, but the results of this study require confirmation from a larger sample with a precise assessment of comorbidity.
多项证据表明多巴胺在强迫症(OCD)的病理生理学中起作用。事实上,一些试验已显示添加抗精神病药物对治疗OCD患者有效。在本研究中,我们评估了8名符合DSM-III-R标准的无药物治疗的OCD住院患者(6名男性,2名女性;平均年龄±标准差=34.7±12.6岁)且无重度抑郁,对皮下注射0.5mg阿扑吗啡的生长激素(GH)反应,并将他们的反应与8名健康男性志愿者(平均年龄=27.1±8.5岁)的反应进行比较。两组的平均GH峰值反应无差异:OCD患者为12.4±9.7ng/mL,正常对照为21.1±14.2ng/mL(F=0.9,自由度1,14,P=0.37)。这些结果不支持OCD中多巴胺能活性过高的假说。实际上,2名OCD患者对阿扑吗啡的GH反应完全迟钝,提示OCD存在生物学异质性。在合并其他诊断的患者或对血清素再摄取抑制剂无反应的患者中可能观察到一些多巴胺能紊乱,但本研究结果需要更大样本并精确评估合并症来加以证实。