背景:躁狂抑郁性精神病(MDP)或双相情感障碍,在全球和印度人口中普遍存在的精神疾病,已被归因于各种病理机制。硫化氢(H2S),气体发射器家族的一员,可能与双相情感障碍的发展有关,因为它在维持适当的神经元功能方面起着至关重要的作用,可塑性,和稳态函数。在MDP中,关于气体传送器H2S的作用的数据很少,诊断能力,和严重程度预测,这导致我们在西孟加拉邦亚喜马拉雅地区的MDP患者中进行这项研究。
方法:这是一项在生物化学系进行的观察性病例对照研究,北孟加拉医学院和医院,Siliguri,西孟加拉邦,印度,从2022年1月到2022年12月。研究了50名诊断为MDP的患者和50名符合纳入和排除标准的健康年龄和性别匹配的对照受试者。使用标准化的分光光度亚甲蓝方法测定血液中的H2S水平。采用汉密尔顿抑郁量表(HAM-D)评分评估抑郁的严重程度。
结果:在50例MDP患者中,45人(90%)处于抑郁期,五个(10%)处于躁狂期。在45名抑郁症患者中,8人(17.8%)患有轻度抑郁症,12人(26.7%)有中度抑郁,19人(42.2%)患有严重抑郁症,6人(13.3%)有非常严重的抑郁症。MDP患者的平均H2S水平(41.98±18.88μmol/l)显着(P<0.05)低于对照组(99.20±15.20μmol/l)。还观察到MDP患者中的平均H2S水平随着疾病的持续时间而降低,但没有统计学意义。发现不同抑郁严重程度组的平均H2S水平存在显着差异(P<0.001)。受试者工作特征(ROC)曲线分析显示H2S的截止值<78.5μmol/l与MDP有关,灵敏度为96%,特异性为88%,H2S的临界值<53μmol/l可预测抑郁症的严重程度,敏感性为89.3%,特异性为76.5%。
结论:MDP患者中气体传输型H2S的显著相关性及其作为诊断和严重程度预测指标的作用可以帮助我们采取适当的措施来更好地管理MDP并改善生活质量。
BACKGROUND: Manic depressive psychosis (MDP) or bipolar disorder, a prevalent psychiatric condition globally and in the Indian population, has been attributed to various pathological mechanisms. Hydrogen sulphide (H2S), a member of the
gasotransmitter family, may be linked to the development of bipolar disorder because it plays a crucial role in maintaining proper neuronal function in terms of excitability, plasticity, and homeostatic functions. There is very little data regarding the role of the
gasotransmitter H2S in MDP in terms of its association, diagnostic ability, and severity prediction, which led us to conduct this study among MDP patients in the Sub-Himalayan region of West Bengal.
METHODS: This was an observational case-control study performed in the Department of Biochemistry, North Bengal Medical College and Hospital, Siliguri, West Bengal, India, from January 2022 to December 2022. Fifty diagnosed MDP patients and 50 healthy age- and sex-matched control subjects satisfying the inclusion and exclusion criteria were studied. The H2S level in the blood was assayed using the standardised spectrophotometric methylene blue method. The severity of depression was assessed by Hamilton Depression Rating Scale (HAM-D) scoring.
RESULTS: Of the 50 MDP patients, 45 (90%) were in the depressive phase, and five (10%) were in the manic phase. Of the 45 depressive patients, eight (17.8%) had mild depression, 12 (26.7%) had moderate depression, 19 (42.2%) had severe depression, and six (13.3%) had very severe depression. The mean H2S level in MDP patients (41.98±18.88 μmol/l) was significantly (P<0.05) lower than that in control subjects (99.20± 15.20 μmol/l). It was also observed that the mean H2S level in MDP patients decreased with the duration of the disease but was not statistically significant. The mean H2S levels in the different depression severity groups were found to be significantly different (P<0.001). Receiver operating characteristic (ROC) curve analysis revealed that a cut-off value of H2S <78.5 μmol/l was associated with MDP, with a sensitivity of 96% and a specificity of 88%, and a cut-off value of H2S < 53 μmol/l predicted the severity of depression with a sensitivity of 89.3% and a specificity of 76.5%.
CONCLUSIONS: The significant association of the
gasotransmitter H2S in MDP patients and its role as a diagnostic and severity predictive marker can help us to employ proper measures for better management of MDP and improving quality of life.