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Trh test and dexamethasone suppression test in schizoaffective mania and mania comparison with schizophrenia

, : Trh test and dexamethasone suppression test in schizoaffective mania and mania comparison with schizophrenia. Journal of the Osaka City Medical Center 36(3): 391-414

To elucidate the neuroendocrine abnormalities of schizoaffective mania and mania, thyrotropin-releasing hormone (TRH) test and dexamethasone suppression test (DST) were carried out in 10 patients who met the Research Diagnostic Criteria (RDC) for schizoaffective mania, 9 who met criteria for mania and 27 who met criteria for schizophrenia. The results were as follows; A blunted thyroid-stimulating hormone (TSH) response (.DELTA. was TSH .ltoreq. 5.0 .mu. U/ ml) to TRH was observed in 3 (30%) of the 10 schizoaffective manics, 4 (44%) of the 9 manics and 3 (11%) of the 27 schizophrenics. The incidence of blunted TSH in schizoaffective manics and manics tended to be higher than that in schizoprenics. Non-suppression (> 5 .mu.g/ dl) on the DST was observed in 5 (50%) of the 10 schizoaffective manics, 2 (22%) of the 9 manics and 2 (9%) of the 22 schizophrenics. The incidence of abnormal DST in schizoaffective mainics was significantly higher (p <. 05) than that in schizophrenics. The results of the TRH test and DST, taken together, indicated that either a blunted TSH response or an abnormal DST was found in 6(60%) of the 10 schizoaffective manics, 5 (56%) of the manics and 3 (14%) of the 22 schizophrenics. The incidience of these abnormalities in schizoaffective manics and was significantly higher (p < .05) than that noted in the schizophrenics. Four schizoaffective manics clinically recovered within six months showed a DST abnormality, whereas among six who did not recover after six months, only one showed a DST abnormality. The difference in incidence of DST abnormality between two groups was statistically significant (p < .05). These results suggest that schizoaffective mania may share similar neuroendocrine abnormalities with mania but not with schizophrenia, such as dysfunctions of the hypothalamus-pituitary-adrenal or-thyroid axes. A combination of the TRH test and DST may serve to differentiate schizoaffective mania or mania from schizophrenia, and DST may be useful in predicting the outcome of schizoaffective mania.

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