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Prediction by Cerebrospinal Fluid 5-Hydroxyindoleacetic Acid, Homovanillic Acid, and Autonomic Measures?

Markus J. P. Kruesi, MD; Euthymia D. Hibbs, PhD; Theodore P. Zahn, PhD; Cynthia S. Keysor; Susan D. Hamburger, MS; John J. Bartko, PhD; Judith L. Rapoport, MD

Arch Gen Psychiatry. 1992;49(6):429-435.

Abstract
• A 2-year prospective follow-up study of 100% (N = 29) of a sample of children and adolescents with disruptive behavior disorders found that the baseline lumbar cerebrospinal fluid monoamine metabolite concentration and autonomic nervous system activity predicted some subsequent outcomes. The 5-hydroxyindoleacetic acid concentration significantly predicted severity of physical aggression during follow-up. The skin conductance level significantly predicted institutionalization. Correlations were in predicted directions with lower cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations and autonomic activity correlated with poor outcome. Moreover, in multivariate analyses, which included nonlaboratory measures as predictors, cerebrospinal fluid and autonomic measures still contributed significantly to the prediction. However, hypothesized predictions of cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations for suicide attempts and of low autonomic nervous system activity for arrests were not supported thus far. Patients are still at risk; consequently, these results must be considered preliminary. Nonetheless, the results suggest that further investigation of relationships between biological factors and outcome of children with disruptive behavior disorders is warranted.

Author Affiliations
From the Child Psychiatry (Drs Kruesi and Rapoport and Mss Keysor and Hamburger) and Child and Adolescent Disorders Research (Dr Hibbs) Branches, the Laboratory of Psychology and Psychopathology (Dr Zahn), and the Division of Applied and Services Research (Dr Bartko), National Institute of Mental Health, Bethesda, Md. Dr Kruesi is now with the Department of Psychiatry, Division of Child and Adolescent Psychiatry, Institute for Juvenile Research, University of Illinois, Chicago.

Footnotes
Accepted for publication March 9, 1992.

Presented in part at the New Research Program of the 144th Annual Meeting of the American Psychiatric Association, New Orleans, La, May 13, 1991.

Reprints not available.

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