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P.2.116 Association study of dopamine transporter gene 3′UTR VNTR polymorphism in bipolar affective disorder
P2 Affective disorders and an6dept~ssants
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of education, 37% lives with parents and 55% perceived a pension. No significant differences were observed in socio-demographic features. The mean age of onset for BD-I patients (35; s.d. 13.5) was significantly lower (p < 0.05) than those with MDD (43; s.d. 16.5) and the mean age of the first contact with mental health services for BD-I patients (36; s.d. 12.9) was significantly lower (p < 0.05) than those with MDD (47; s.d. 14.8) and Dysthymia (52; s.d. 17.2). 39% (N 63) had at least one coexisting psychiatric disorder; such as Personality Disorders (PDs) (N 36; 57%), Substance Abuse Disorders (N 21; 33%) and Anxiety Disorders (N 5; 8%). Interestingly, patients with Dysthymia (N 17; 77%) presented significantly higher comorbid conditions (p < 0.05) than those with MDD (N 32; 39%) and BD-I (N 14; 24%). PDs were the most frequent comorbidity in both MDD (N 20; 24%) and BD-I (N 9; 16%), while Substance Abuse Disorders (N 8; 36%) were frequently associated with Dysthymia. 61% (N 99) had comorbid medical conditions. 32% (N 52) presented only one medical pathology and 29% (N 47) more than one. The most frequent medical comorbidities were the cardio-vascular disorders (N 28; 28%), followed by immune (N 18; 18%), gastro-intestinal (N 14; 14%), liver (N 10; 10%), metabolic and endocrine disorders (N 9; 9%). The mean total BPRS score at the admission was 47 (s.d. 8.9) and 35 (s.d. 6.8) at the discharge. The differences between admission and discharge showed a significant decrease of symptom's severity (p < 0.05). Although total GAF scores showed a significant improvement at the discharge (47; s.d. 10.7; score at admission: 41; s.d. 11.0) (p <0.05), patients still had a low level of functioning. Conclusions: Our findings further support the concept that Mood Disorders often are severe and chronic illnesses. Improved detection and treatment of coexisting conditions in affective patients will have significant benefits for their psychosocial functioning and overall quality of life.
the psychostimulants can provoke manic episodes in susceptible individuals. DAT protein level is also reported to be elevated in major depression. There are only few published studies concerning 3'UTR VNTR polymorphism in bipolar affective disorder. M e t h o d s : We investigated 3'UTR VNTR polymorphism in patients (n 336) psychiatrically screened for bipolar affective disorder according to DSM-IV criteria and in control subjects (n 362), all from Polish population of Wielkopolska region. There were 288 bipolar I patients, and 48 bipolar II patients, among all bipolar aptients there were 29 individuals with age at onset before 18 years. DAT polymorphism was assessed by PCRVNTR method. Informed consent from individuals participating in the study was obtained. Results: Comparing the patients with bipolar affective disorder with controls we did not observe any statistically significant differences in the frequency of the alleles (p 0.273 for whole group, p 0.346 for males; p 0.512 for females) and genotypes (p 0.116 for whole group, p 0.607 for males; p 0.072 for females). A weak association with A9 allele was present in early onset subgroup (p 0.047). For a small subgroup of bipolar II patients (n 48) we observed an association with A9 allele (p 0.009) as well as with A9/A9 and A9/A10 alleles (p 0.007). Conclusion: We did not find an association of 3'UTR VNTR polymorphism of DAT gene with bipolar affective disorder. However we observed an association in a relatively small subgroup of bipolar II patients. For a confirmation or rejection of our observations further studies on much larger groups, and with other polymorphisms within DAT gene are required.
References
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[1] Sala, M., Perez, J., Solff, P., Ucelli di Nemi, S., Caverzasi, E., Soares, J.C., Brambilla, P., 2004. Stress and hippocampal abnormalities in psychiatric disorders. European Neuropsychopharmacology 14:393 405. [2] Wells, K.B., Stewart, A., Hays, R.D., Burnam, A., Rogers, W., Daniels, M., Berry, S., Greenfield, S., Ware, J., 1989. The functioning and well-being of depressed patients. Result from the medical outcomes study. JAMA 262: 914-919. [3] Simon, G.E., Von Korff, M., Lin, E., 2004. Clinical and functional outcomes of depression treatment in patients with and without chronic medical illness. Psychological Medicine 34:1 9.
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Association study of dopamine transporter gene 3tUTR VNTR polymorphism in bipolar affective disorder
RM. Czerski*, A. Leszczynska-Rodziewicz, M. Skibinska, M. Dmitrzak-W6glarz, R Kapelski, M. Kaczmarkiewicz-Fass, M. Kosmowska, J.K. Rybakowski, J. Hauser. Poznan University
of Medical Sciences, Department of Psychiatty, Poznan, Poland Objective: Dopaminergic system has been implicated in the etiology of bipolar disorder. Most studies have reported the decrease of cerebrospinal fluid homovanilic acid, the major dopamine metabolite in depressed patients. Also the inactivation of dopamine would lead to anhedonia, the feature which is often found in depressed patients. Chronic use of psychostimulants increases the dopamine transporter (DAT) levels during withdrawal, since the DAT protein is target for the amphetamine and cocaine. Long term use of
References [1] Vandenbergh DJ, Persico AM, Hawkins AL, Griffin CA, Li X, Wang Jabs E, Uhl GR. 1992, Human dopamine transporter gene (DAT-1) maps to chromosome 5p15.3 and displays a VNTR. Genomics, 14: 1104-1106.
Correlation beetwen depression and osteporosis
M. Ivkovic 1 . , A. Dam~anovic 1 , M. Petronijevic 2 , M. JasovicGasic 3 , V.R. Paunovic ,. . 1Institute for Psychiatry, Affective
Disorders, Belgrade, Yugoslavia; 2Militaty Academy, Rentgenology, Yugoslavia; 3Institute for Psychiatty, Psychotic Disorders, Yugoslavia; 4Institute for Psychiatty, Affective Disorders, Yemen B a c k g r o u n d : Depression is the most common psychiatric dis-
order with growing incidence in developed, urban areas and in younger age. Epidemiological studies show that women suffer from depression twice as men, which could indicate correlation between estrogen level and affective disorders. Estrogen has an important role in bone metabolism which opens a question on potential relationship between depression and osteoporosis. Aim of this paper was to investigate if depression, independently of other risk factors, affects bone density and if lasting, severity or antidepressants could influence bone metabolism. M e t h o d s : Sample consists of 60 pre- and postmenopausal patients with Recurrent depressive disorder, lasting at least 2 years before the study, and the same number of healthy controls. Relevant anamnestic data were collected; Hamilton Depression Rating Scale score and DEXA osteodensimetry were performed on all participants. Results: 12 out of 30 patients had lumbal osteoporosis and 9 out 30 had femoral osteoporosis in premenopausal group. Osteoporosis was not observed in healthy premenopausal women. 6out of 30
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of education, 37% lives with parents and 55% perceived a pension. No significant differences were observed in socio-demographic features. The mean age of onset for BD-I patients (35; s.d. 13.5) was significantly lower (p < 0.05) than those with MDD (43; s.d. 16.5) and the mean age of the first contact with mental health services for BD-I patients (36; s.d. 12.9) was significantly lower (p < 0.05) than those with MDD (47; s.d. 14.8) and Dysthymia (52; s.d. 17.2). 39% (N 63) had at least one coexisting psychiatric disorder; such as Personality Disorders (PDs) (N 36; 57%), Substance Abuse Disorders (N 21; 33%) and Anxiety Disorders (N 5; 8%). Interestingly, patients with Dysthymia (N 17; 77%) presented significantly higher comorbid conditions (p < 0.05) than those with MDD (N 32; 39%) and BD-I (N 14; 24%). PDs were the most frequent comorbidity in both MDD (N 20; 24%) and BD-I (N 9; 16%), while Substance Abuse Disorders (N 8; 36%) were frequently associated with Dysthymia. 61% (N 99) had comorbid medical conditions. 32% (N 52) presented only one medical pathology and 29% (N 47) more than one. The most frequent medical comorbidities were the cardio-vascular disorders (N 28; 28%), followed by immune (N 18; 18%), gastro-intestinal (N 14; 14%), liver (N 10; 10%), metabolic and endocrine disorders (N 9; 9%). The mean total BPRS score at the admission was 47 (s.d. 8.9) and 35 (s.d. 6.8) at the discharge. The differences between admission and discharge showed a significant decrease of symptom's severity (p < 0.05). Although total GAF scores showed a significant improvement at the discharge (47; s.d. 10.7; score at admission: 41; s.d. 11.0) (p <0.05), patients still had a low level of functioning. Conclusions: Our findings further support the concept that Mood Disorders often are severe and chronic illnesses. Improved detection and treatment of coexisting conditions in affective patients will have significant benefits for their psychosocial functioning and overall quality of life.
the psychostimulants can provoke manic episodes in susceptible individuals. DAT protein level is also reported to be elevated in major depression. There are only few published studies concerning 3'UTR VNTR polymorphism in bipolar affective disorder. M e t h o d s : We investigated 3'UTR VNTR polymorphism in patients (n 336) psychiatrically screened for bipolar affective disorder according to DSM-IV criteria and in control subjects (n 362), all from Polish population of Wielkopolska region. There were 288 bipolar I patients, and 48 bipolar II patients, among all bipolar aptients there were 29 individuals with age at onset before 18 years. DAT polymorphism was assessed by PCRVNTR method. Informed consent from individuals participating in the study was obtained. Results: Comparing the patients with bipolar affective disorder with controls we did not observe any statistically significant differences in the frequency of the alleles (p 0.273 for whole group, p 0.346 for males; p 0.512 for females) and genotypes (p 0.116 for whole group, p 0.607 for males; p 0.072 for females). A weak association with A9 allele was present in early onset subgroup (p 0.047). For a small subgroup of bipolar II patients (n 48) we observed an association with A9 allele (p 0.009) as well as with A9/A9 and A9/A10 alleles (p 0.007). Conclusion: We did not find an association of 3'UTR VNTR polymorphism of DAT gene with bipolar affective disorder. However we observed an association in a relatively small subgroup of bipolar II patients. For a confirmation or rejection of our observations further studies on much larger groups, and with other polymorphisms within DAT gene are required.
References
•
[1] Sala, M., Perez, J., Solff, P., Ucelli di Nemi, S., Caverzasi, E., Soares, J.C., Brambilla, P., 2004. Stress and hippocampal abnormalities in psychiatric disorders. European Neuropsychopharmacology 14:393 405. [2] Wells, K.B., Stewart, A., Hays, R.D., Burnam, A., Rogers, W., Daniels, M., Berry, S., Greenfield, S., Ware, J., 1989. The functioning and well-being of depressed patients. Result from the medical outcomes study. JAMA 262: 914-919. [3] Simon, G.E., Von Korff, M., Lin, E., 2004. Clinical and functional outcomes of depression treatment in patients with and without chronic medical illness. Psychological Medicine 34:1 9.
•
Association study of dopamine transporter gene 3tUTR VNTR polymorphism in bipolar affective disorder
RM. Czerski*, A. Leszczynska-Rodziewicz, M. Skibinska, M. Dmitrzak-W6glarz, R Kapelski, M. Kaczmarkiewicz-Fass, M. Kosmowska, J.K. Rybakowski, J. Hauser. Poznan University
of Medical Sciences, Department of Psychiatty, Poznan, Poland Objective: Dopaminergic system has been implicated in the etiology of bipolar disorder. Most studies have reported the decrease of cerebrospinal fluid homovanilic acid, the major dopamine metabolite in depressed patients. Also the inactivation of dopamine would lead to anhedonia, the feature which is often found in depressed patients. Chronic use of psychostimulants increases the dopamine transporter (DAT) levels during withdrawal, since the DAT protein is target for the amphetamine and cocaine. Long term use of
References [1] Vandenbergh DJ, Persico AM, Hawkins AL, Griffin CA, Li X, Wang Jabs E, Uhl GR. 1992, Human dopamine transporter gene (DAT-1) maps to chromosome 5p15.3 and displays a VNTR. Genomics, 14: 1104-1106.
Correlation beetwen depression and osteporosis
M. Ivkovic 1 . , A. Dam~anovic 1 , M. Petronijevic 2 , M. JasovicGasic 3 , V.R. Paunovic ,. . 1Institute for Psychiatry, Affective
Disorders, Belgrade, Yugoslavia; 2Militaty Academy, Rentgenology, Yugoslavia; 3Institute for Psychiatty, Psychotic Disorders, Yugoslavia; 4Institute for Psychiatty, Affective Disorders, Yemen B a c k g r o u n d : Depression is the most common psychiatric dis-
order with growing incidence in developed, urban areas and in younger age. Epidemiological studies show that women suffer from depression twice as men, which could indicate correlation between estrogen level and affective disorders. Estrogen has an important role in bone metabolism which opens a question on potential relationship between depression and osteoporosis. Aim of this paper was to investigate if depression, independently of other risk factors, affects bone density and if lasting, severity or antidepressants could influence bone metabolism. M e t h o d s : Sample consists of 60 pre- and postmenopausal patients with Recurrent depressive disorder, lasting at least 2 years before the study, and the same number of healthy controls. Relevant anamnestic data were collected; Hamilton Depression Rating Scale score and DEXA osteodensimetry were performed on all participants. Results: 12 out of 30 patients had lumbal osteoporosis and 9 out 30 had femoral osteoporosis in premenopausal group. Osteoporosis was not observed in healthy premenopausal women. 6out of 30