title: Lifetime burden of mood swings and activation of brain norepinephrine turnover in patients with treatment-refractory depressive illness.
abstract: BACKGROUND
  We tested if duration and intensity of episodes in treatment-resistant affectively ill patients were related to cerebrospinal fluid (CSF) concentrations of monoamine metabolites.
  
  
  METHODS
  In retrospective life charts were recorded every previous episode of 37 patients with severe treatment-refractory affective disorders. 'Accumulated burden of mood swings' (ABMS, sum of each episode length x episode depth) was used to estimate the accumulated illness burden. Homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were analyzed in CSF of all patients and compared with 27 healthy controls. Data were analyzed using multiple regression analysis.
  
  
  RESULTS
  CSF MHPG contributed strongly significant and positively to the ABMS.
  
  
  CONCLUSIONS
  The retrospective nature of the study.
  
  
  CONCLUSIONS
  CSF concentrations of MHPG is positively related to ABMS over life. Thus, a specific involvement of norepinephrine in the long-term burden of affective illness is a likely reality.
authors.affiliation: Research and Developmental Unit, FoU, Varberg Hospital, SE-432 81 Varberg, Sweden. anna.ehnvall@lthalland.se
authors.forename: Anna
authors.initials: A
authors.lastname: Ehnvall
authors.forename: Magnus
authors.initials: M
authors.lastname: Sjögren
authors.forename: Olof C G
authors.initials: OC
authors.lastname: Zachrisson
authors.forename: Hans
authors.initials: H
authors.lastname: Agren
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000378:metabolism*; D003866:Depressive Disorder / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood; D008875:Middle Aged; D019964:Mood Disorders / Q000134:cerebrospinal fluid / Q000150:complications* / Q000378:metabolism*; D009638:Norepinephrine / Q000378:metabolism*; D012189:Retrospective Studies; D013129:Spinal Puncture
chemical_list: D000928:Antidepressive Agents; D008734:Methoxyhydroxyphenylglycol; D009638:Norepinephrine; D006719:Homovanillic Acid