MalcolmB. Bowers

CSF TRYPTOPHAN, 5-HIAA AND HVA IN 132 PSYCHIATRIC PATIENTS CATEGORIZED BY DIAGNOSIS AND CLINICAL STATE

Cerebrospinal fluid (CSF) concentrations of probenecid (PRO), tryptophan (TRY), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA) were measured in a diagnostically heterogeneous group of 132 psychiatric inpatients. Bipolar, manic patients were found to have significantly higher mean levels of CSF HVA than bipolar, depressed patients (p <.05). Otherwise, no significant differences between any of the major diagnostic groups were observed for any of the CSF measures. Among the 74 patients rated as clinically depressed at the time of the lumbar puncture (LP), both CSF TRY and 5-HIAA were positively correlated with severity of depressed mood. CSF TRY was also negatively correlated with psychomotor retardation and CSF 5-HIAA was positively correlated with psychomotor agitation. The correlation between CSF TRY and severity of depressed mood was enhanced by statistically controlling for the effects of psychomotor retardation (r = 0.47, N = 53, p <. 001). Similarly, the negative correlation between CSF TRY and psychomotor retardation was enhanced by controlling for the severity of depressed mood (r = −0.52, N = 53, p <. 0001). A similar analysis involving the subgroup of patients who were actively psychotic at the time of the LP did not yield significant results. The implications of these findings are discussed.