Objectives: To investigate the relationship between plasma dopamine level and clinical features in patients with bipolar disorder, manic episode. Subjects and methods: The study included 62 inpatients with bipolar disorder, manic episode, who were received treatment at National Psychiatric Hospital No 1, from July 2015 to December 2017.
Trang 1STUDYING THE RELATIONSHIP BETWEEN PLASMA
DOPAMINE LEVELS AND CLINICAL CHARACTERISTICS
OF BIPOLAR DISORDER, MANIC EPISODE
Nguyen Manh Phat*; Ngo Ngoc Tan**; Nguyen Trong Dao**
SUMMARY
Objectives: To investigate the relationship between plasma dopamine level and clinical
features in patients with bipolar disorder, manic episode Subjects and methods: The study
included 62 inpatients with bipolar disorder, manic episode, who were received treatment at
National Psychiatric Hospital No 1, from July 2015 to December 2017 Use criteria ICD-10 for
diagnosis Use method of prospective, cross-sectional, case-by-case analysis Test plasma
dopamine twice (first time in week 1, second time after first time 25 - 30 days) The data were
processed by medical statistics using program STATA 12.0 Results: After a period of treatment,
mean plasma dopamine levels in patients decreased significantly with p < 0.001 (from 31.40 ±
7.38 ng/L in first time to 17.66 ± 5.95 ng/L in the second time) Plasma dopamine levels were
statistically significantly decreased in patients with diagnostic groups F31.1 and F31.2 Plasma
dopamine levels were statistically significant decreased in patients with increased mood, emotional
tension, hyperactivity, agitated activity and grandiose delusions Conclusion: Plasma dopamine
levels significantly associated with many symptoms of manic episode
* Keywords: Bipolar disorder; Plasma dopamine levels
INTRODUCTION
The manic episode in bipolar disorder
has many symptoms with diverse clinical
manifestation Dopamine plays an important
role in the pathogenesis of bipolar mood
disorder, the manic episode In Vietnam,
there is no study on the relationship between
clinical characteristics and plasma dopamine
levels in patients with bipolar disorders,
the manic episode Objectives of the study:
To study the relationship between plasma
dopamine levels and clinical characteristics
of bipolar disorder, the manic episode
SUBJECTS AND METHODS
1 Subjects
62 inpatients with bipolar disorder, the manic episode, who was received treatment
at National Psychiatric Hospital No 1, from July 2015 to December 20107
2 Methods
- Use criteria ICD-10 for diagnosis
- A prospective, cross-sectional, case-by-case analysis Test plasma dopamine twice by ANOVA single factor methods
* National Psychiatric Hospital No 1
** 103 Military Hopsital
Corresponding author: Nguyen Manh Phat (bsphat1999@gmail.com)
Date received: 17/05/2018
Date accepted: 21/06/2018
Trang 2- Time for the dopamine plasma test:
+ First time in week 1, after hospitalization
+ Second time after first time 25 - 30 days
The data were processed by medical statistics using program STATA 12.0
RESULTS
Table 1: Plasma dopamine levels in patients
Statistical index
The first time test: n = 62; X= 34.40 ng/L; SD = 7.38 ng/L; SE = 0.94; CI = 29.52 - 33.27 The second time test: n = 62; X= 17.66 ng/L; SD = 5.95 ng/L; SE = 0.75; CI = 16.15 - 19.18 The two surveys of test dopamine had statistically significant differences with p < 0.001
Table 2: Relationship between diagnostic groups and plasma dopamine levels
Plasma dopamine levels (ng/L) Statistical index
Groups
n = 62
Test 1 time (t 1 ) Test 2 time (t 2 ) p 1 , 2
(1: t 1 - t 2 = 2.3310 and p 1 - p 2 = 0.0802; 2: t 1 - t 2 = 8.4377 and p 1 - p 2 = 0.0000; 3: t 1 -
t 2 = 13.6622 and p 1 - p 2 = 0.0000)
Plasma dopamine levels in 2 surveys of F31.1 and F31.2 were statistically significant differences with p < 0.001
Table 3: Relationship between plasma dopamine levels and mood symptoms
Plasma dopamine levels (ng/L)
Test 1 time (t 1 ) Test 2 time (t 2 )
Statistical index
Symptoms
p 1 = p 2
(1: t 1 - t 2 = 9.8928 and p = 0.0000; 2: t 1 - t 2 = 13.29 and p = 0.094; 3.: t 1 - t 2 = 10.5855 and p = 0.113; 4: t 1 - t 2 = 11.1473 and p = 0.016)
Trang 3Plasma dopamine levels in 2 surveys of increasing mood were statistically significant differences with p < 0.001
Plasma dopamine levels in 2 surveys of tensive mood had statistically significant differences with p < 0.05
Table 4: Relationship between plasma dopamine levels and activity
Plasma dopamine levels (ng/L)
Test 1 time (t 1 ) Test 2 time (t 2 )
Statistical index
Disorder of activity n = 62 (X ± SD) n = 62 (X = SD)
p 1 = p 2
Interfering in everything n = 34 31.90 ± 7.88 n = 4 22.92 ± 6.32 p < 0.05
Do not cooperate on
(1: t 1 - t 2 = 8.6597 and p = 0.001; 2: t 1 - t 2 = 8.9810 and p = 0.035; 3: t 1 - t 2 = 2.5769 and p = 0.738; 4: t 1 - t 2 = 11.0361 and p = 0.0181; 5: t 1 - t 2 = 5.6708 and p = 0.408)
Plasma dopamine levels in 2 surveys of hyperactivity were statistically significant differenct with p < 0.01
Plasma dopamine levels in 2 surveys of interfering in everything and hysterical activity were statistically significant differences (p < 0.05)
Table 5: Relationship between plasma dopamine levels and delusions
Plasma dopamine levels (ng/L)
Test 1 time (t 1 ) Test 2 time (t 2 )
Statistical index
Kind of delusion
p 1 = p 2
(1: t 1 - t 2 = 0 and p = 0; 2: t 1 - t 2 = 19.3457 and p = 0.0000; 3: t 1 - t 2 = 0 and p = 0)
Plasma dopamine levels in 2 surveys of grandiose delusions were statistically significant differences with p < 0.001)
DISCUSSION
The first time test: n = 62; X= 34.40 ng/L;
SD = 7.38 ng/L; SE = 0.94; CI = 29.52 -
33.27 The second time test: n = 62;
X = 17.66 ng/L; SD = 5.95 ng/L; SE = 0.75;
CI = 16.15 - 19.18 The two surveys of test dopamine were statistically significant difference with p < 0.001
Ambade V et al (2011) found that mean ± standard deviation of plasma dopamine in healthy was 21.8 ± 9.5 ng/L
Trang 4Cousins D.A et al (2009) found that
dopamine plays a very important role in
the pathogenesis of bipolar mood disorders,
mania The authors suggested that dopamine
levels increase and dopaminergic activity
increase in the brain
- Plasma dopamine levels in 2 surveys
of F31.1 and F31.2 were statistically
significant different with p < 0.001
Sadock B.J (2015) supposes that
symptoms of manic episodes without
psychosis and psychosis are similar
- Plasma dopamine levels statistically
significantly decreased in patients with
increasing mood, emotional tension,
hyperactivity, agitated activity and grandiose
delusions
According to Kristina R (2012), dopamine
is a catecholamine that plays a significant
role in bipolar disorders Excess dopamine
activity facilitates mania and delusional
symptoms
John Cookson (2013) found that drugs
with more specific dopamine-receptor
blocking actions have antimanic properties
although these drugs are less sedative,
without blocking actions at histamine or
noradrenaline receptors He supposes
drug treatment (with olanzapine, quetiapine
and presumably the other antipsychotics)
improved the whole range of symptoms
(including elation, flight of ideas, grandiosity,
sexual interest, irritability, aggression,
general appearance and insight, as well
as the items most sensitive to sedation:
insomnia, overactivity and pressure of
speech)
CONCLUSION
After a period of treatment:
- Mean plasma dopamine levels in patients decreased significantly p < 0.001
17.66 ± 5.95ng/L in the second time)
- Plasma dopamine levels were statistically significantly decreased in patients with diagnostic groups F31.1 and F31.2
- Plasma dopamine levels were statistically significantly decreased in patients with increasing mood, emotional tension, hyperactivity, agitated activity and grandiose delusions
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2 Cousins D.A, Butts K, Young A.H. The role of dopamine in bipolar disorder Bipolar Disord: 11, pp.787-806 The Authors Journal Compilation John Wiley & Sons A ⁄S
3 John C. Dopamine hypothesis of Mania Journal of Mood Disorders 3 (Suppl 1), S1-S3 2013
4 Kristina R.S, Bertalan D. Bipolar disorder: Diagnosis, neuroanatomical and biochemical background Clinical research and treatment approaches to affective disorders Edited by
Dr Mario Juruena Published in print edition
2012, February
5 Sadock B.J, Sadock V.A. Mood disorders Synopsis of Psychyatry Eleventh edition
2015, pp.457-486