Toward a biochemical classification of depressive disorders. I. Differences in urinary excretion of MHPG and other catecholamine metabolites in clinically defined subtypes of depressions.

The urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) and other catecholamine metabolites was measured in a series of 63 patients with various clinically defined subtypes of depressive disorders. MHPG excretion was significantly lower in patients with bipolar manic-depressive depressions and schizo-affective depressions than in patients with unipolar nonendogenous depressions. Patients with schizophrenia-related depressions also excreted reduced levels of MHPG when compared with patients with unipolar nonendogenous depressions. Moreover, levels of urinary epinephrine and metanephrine were significantly lower in patients with schizophrenia-related depressions. These data, coupled with our recent finding that patients with schizophrenia-related depressions had significantly higher levels of platelet monoamine oxidase activity than control subjects of patients with unipolar endogenous depressions, suggest that we can discriminate three biochemically discrete subgroups of depressive disorders corresponding to the following clinically defined subtypes: (1) the bipolar manic-depressive depressions plus the schizo-affective depressions; (2) the unipolar nonendogenous depressions; and (3) the schizophrenia-related depressions.

[1]  J. Feighner,et al.  Diagnostic criteria for use in psychiatric research. , 1972, Archives of general psychiatry.

[2]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[3]  J. Maas,et al.  Diagnostic subgroups of affective disorders and their urinary excretion of catecholamine metabolities. , 1975, The American journal of psychiatry.

[4]  J. Axelrod,et al.  3-Methoxy-4-hydroxyphenylglycol sulfate, a new metabolite of epinephrine and norepinephrine. , 1959, Biochimica et biophysica acta.

[5]  D. Murphy,et al.  The "switch process" in manic-depressive illness. II. Relationship to catecholamines, REM sleep, and drugs. , 1972, Archives of general psychiatry.

[6]  J. Schildkraut,et al.  The catecholamine hypothesis of affective disorders: a review of supporting evidence. , 1965, The American journal of psychiatry.

[7]  J. Schildkraut,et al.  3-methoxy-4-hydroxyphenylglycol sulfate in brain and cerebrospinal fluid. , 1968 .

[8]  C. Rutledge,et al.  Metabolic pathways of dopamine and norepinephrine in rabbit brain in vitro. , 1967, The Journal of pharmacology and experimental therapeutics.

[9]  A. Anton,et al.  A study of the factors affecting the aluminum oxide-trihydroxyindole procedure for the analysis of catecholamines. , 1962, The Journal of pharmacology and experimental therapeutics.

[10]  A. Schatzberg,et al.  Elevated platelet MAO activity in schizophrenia-related depressive disorders. , 1978, The American journal of psychiatry.

[11]  R. Wurtman,et al.  EFFECT OF SELECTIVE DESTRUCTION OF CENTRAL AND PERIPHERAL CATECHOLAMINE‐CONTAINING NEURONES WITH 6‐HYDROXYDOPAMINE ON CATECHOLAMINE EXCRETION IN THE RAT , 1974, British journal of pharmacology.

[12]  G. Sampson,et al.  Daily variations of the urine content of 3-methoxy-4-hydroxyphenylglycol in two manic-depressive patients , 1972, Psychological Medicine.

[13]  J. Schildkraut,et al.  Amphetamine withdrawal: affective state, sleep patterns, and MHPG excretion. , 1972, The American journal of psychiatry.

[14]  J. Maas,et al.  In vivo studies of the metabolism of norepinephrine in the central nervous system. , 1968, The Journal of pharmacology and experimental therapeutics.

[15]  L. Stein,et al.  Self-stimulation reward pathways: norepinephrine vs dopamine. , 1974, Journal of psychiatric research.

[16]  D. Clarke,et al.  A quantitative assay for vanillylmandelic acid (VMA) by gas-liquid chromatography. , 1965, Analytical biochemistry.

[17]  M. Taylor,et al.  Manic-depressive illness and good prognosis schizophrenia. , 1975, The American journal of psychiatry.

[18]  D. German,et al.  Catecholamine systems as the neural substrate for intracranial self-stimulation: a hypothesis. , 1974, Brain research.

[19]  Kopin Ij,et al.  Differential labelling of origins of urinary catecholamine metabolites by dopamine-C14. , 1975 .

[20]  G. Heninger,et al.  Urinary 3-methoxy-4-hydroxyphenylglycol and psychiatric diagnosis. , 1978, The American journal of psychiatry.

[21]  S. Subrahmanyam.  Role of biogenic amines in certain pathological conditions , 1975, Brain Research.

[22]  W. Bunney,et al.  The switch process in manic‐depressive illness , 1978 .

[23]  J. Schildkraut,et al.  Catecholamine metabolism in affective disorders. I. Normetanephrine and VMA excretion in depressed patients treated with imipramine. , 1965, Journal of psychiatric research.

[24]  M S Buchsbaum,et al.  Alterations in motor activity, sleep, and biochemistry in a cycling manic-depressive patient. , 1977, Archives of general psychiatry.

[25]  J. Maas,et al.  Urinary Catecholamine Metabolites during Behavioral Changes in a Patient with Manic-Depressive Cycles , 1973, Science.

[26]  D. E. Redmond,et al.  Catecholamine metabolite excretion following intraventricular injection of 6-OH-dopamine. , 1972, Brain research.

[27]  W. Procci.  Schizo-affective psychosis: fact or fiction? A survey of the literature. , 1976, Archives of general psychiatry.

[28]  J. Schildkraut,et al.  Metabolism of normetanephrine-H3 in rat brain--identification of conjugated 3-methoxy-4-hydrophenylglycol as the major metabolite. , 1968, Biochemical pharmacology.

[29]  D. Murphy,et al.  Stimulation by lithium of monoamine uptake in human platelets. , 1969, Life sciences.

[30]  D. Murphy,et al.  Reduced monoamine oxidase activity in blood platelets from bipolar depressed patients. , 1972, The American journal of psychiatry.

[31]  J. Maas,et al.  Catecholamine metabolism, depressive illness, and drug response. , 1972, Archives of general psychiatry.

[32]  R. Wyatt,et al.  Estimation of the contribution of peripheral and central noradrenergic neurones to urinary 3-methoxy-4-hydroxyphenylglycol in the rat. , 1974, Neuropharmacology.

[33]  J. Schildkraut.  Neuropsychopharmacology and the Affective Disorders , 1969 .

[34]  J. Maas,et al.  An improved procedure of 3-methoxy-4-hydroxyphenyl-ethylene glycol determination by gas-liquid chromatography. , 1970, Analytical biochemistry.

[35]  J. Glowinski,et al.  METABOLISM OF [3H]NOREPINEPHRINE IN THE RAT BRAIN , 1965, Journal of neurochemistry.

[36]  J. Schildkraut,et al.  MHPG Excretion in Depressive Disorders: Relation to Clinical Subtypes and Desynchronized Sleep , 1973, Science.

[37]  Post Rm,et al.  Studies of amine metabolites in affective illness and in schizophrenia: a comparative analysis. , 1975 .