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I. Differences in Urinary Excretion of MHPG and Other Catecholamine Metabolites in Clinically Defined Subtypes of Depressions

Joseph J. Schildkraut, MD; Paul J. Orsulak, PhD; Alan F. Schatzberg, MD; Jon E. Gudeman, MD; Jonathan O. Cole, MD; William A. Rohde, MD; Richard A. LaBrie, PhD

Arch Gen Psychiatry. 1978;35(12):1427-1433.

Abstract
• The urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) and other catecholamine metabolites was measured in a series of 63 patients with various clinically defined subtypes of depressive disorders. MHPG excretion was significantly lower in patients with bipolar manic-depressive depressions and schizoaffective depressions than in patients with unipolar nonendogenous depressions. Patients with schizophrenia-related depressions also excreted reduced levels of MHPG when compared with patients with unipolar nonendogenous depressions. Moreover, levels of urinary epinephrine and metanephrine were significantly lower in patients with schizophrenia-related depressions. These data, coupled with our recent finding that patients with schizophrenia-related depressions had significantly higher levels of platelet monoamine oxidase activity than control subjects or patients with unipolar endogenous depressions, suggest that we can discriminate three biochemically discrete subgroups of depressive disorders corresponding to the following clinically defined subtypes: (1) the bipolar manic-depressive depressions plus the schizo-affective depressions; (2) the unipolar nonendogenous depressions; and (3) the schizophreniarelated depressions.

Author Affiliations
From the Department of Psychiatry, Harvard Medical School, Boston (Drs Schildkraut, Orsulak, Schatzberg, Gudeman, Cole, and Rohde); the Neuropsychopharmacology Laboratory (Drs Schildkraut and Orsulak) and the Department of Adult Services (Dr Gudeman), Massachusetts Mental Health Center, Boston; the Departments of Psychiatry (Drs Schatzberg and Rohde) and Psychopharmacology (Dr Cole), McLean Hospital, Belmont, Mass; and LaBrie Associates, Cambridge, Mass (Dr LaBrie).

Footnotes
Accepted for publication May 10, 1978.

Reprint requests to Massachusetts Mental Health Center, 74 Fenwood Rd, Boston, MA 02115 (Dr Schildkraut).

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