Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T19:55:42.141Z Has data issue: false hasContentIssue false

Cushing's Syndrome, Tryptophan and Depression

Published online by Cambridge University Press:  29 January 2018

William F. Kelly
Affiliation:
Endocrine Unit, Royal Postgraduate Medical School, London W12 0HS
Stuart A. Checkley
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SE5
David A. Bender
Affiliation:
Courtauld Institute of Biochemistry, The Middlesex Hospital Medical School, London W1P 7PN

Summary

Fifteen patients with active Cushing's syndrome have been compared with 15 other patients who had been treated successfully for Cushing's syndrome and with 13 patients with other pituitary tumours. Depression was the main psychiatric diagnosis made by the CATEGO programme after Present State Examinations. Patients with active Cushing's syndrome were significantly more depressed (Hamilton Rating Scores), than were the other patients. Compared with the control patients, those with active Cushing's syndrome had slightly lower plasma concentrations of total tryptophan, though the concentrations of freely diffusible tryptophan were not significantly changed.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1980 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, K. & Greengard, O. (1966) Correlation of kynurenine excretion with liver tryptophan pyrrolase levels in disease and after hydrocortisone induction. Journal of Clinical Investigations, 45, 1527–34.Google Scholar
Asberg, M. (1979) Biogenic amine metabolites in cerebrospinal fluid from depressed and suicidal patients. Acta Psychiatric Scandinavica. (In press).Google Scholar
Baumann, P. & Perry, M. (1977) The analysis of free tryptophan in human blood with the ultra-filtrator: a comparison with other methods. Clinica Chimica Acta, 76, 223–31.Google Scholar
Beardwell, C. G., Burke, C. W. & Cope, C. L. (1968) Urine free Cortisol measured by competitive protein binding. Journal of Endocrinology, 42, 7989.Google Scholar
Bender, D. A. & Bamji, A. N. (1974) Serum tryptophan binding in chlorpromazine-treated chronic schizophrenics. Journal of Neurochemistry, 22, 805–9.Google Scholar
Bender, D. A., Boulton, A. P. & Coulson, W. F. (1975) A simple method for the study of tryptophan binding to serum albumin by small scale equilibrium dialysis: applications to animal and human studies. Biochemical Society Transactions, 3, 193–4.CrossRefGoogle Scholar
Carroll, B. J. (1976) Psychoendocrine relationships in affective disorders. In Modem Trends in Psychosomatic Medicine (ed. O. W. Hill). Butterworth.Google Scholar
Cope, C. L. (1972) Adrenal steroids and disease. Pitman Medical.Google Scholar
Curzon, G. & Green, A. R. (1971) Regional and subcellular changes in the concentration of 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in rat brain caused by hydrocortisone DL-α-methyltryptophan 1-kynurenine and immobilisation. British Journal of Pharmacology, 43, 3952.Google Scholar
Curzon, G. & Knott, P. J. (1974) Effects on plasma and brain tryptophan in the rat of drugs and hormones that influence the concentration of unesterified fatty acids in the plasma. British Journal of Pharmacology, 50, 197204.Google Scholar
Cushing, H. (1932) The basophil adenomas of the pituitary gland and their clinical manifestations (pituitary basophilism). Bulletin of the Johns Hopkins Medical School, 50, 137–95.Google Scholar
Denckla, W. D. & Dewey, H. K. (1967) The determination of tryptophan in plasma liver and urine. Journal of Laboratory & Clinical Medicine, 69, 160–9.Google Scholar
Fernstrom, J. D., Hirsch, M. J. & Faller, D. V. (1976) Tryptophan concentrations in rat brain. Biochemical Journal, 160, 589–95.Google Scholar
Furger, R. (1961) Psychiatrische Untersuchungen beim Cushing-Syndrom. Schweizer Archiv fuer Neurologic Neurochirugie und Psychiatric, 88, 939.Google Scholar
Green, A. R. & Curzon, G. (1968) Decrease of 5-hydroxytryptamine in the brain provoked by hydrocortisone and its prevention by allopurinol. Nature, 220, 1095–7.Google Scholar
Green, A. R., Woods, H. F., Knott, P. J. & Curzon, G. (1975) Factors affecting influence of hydrocortisone on rat brain tryptophase metabolism. Nature, 255, 270.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–96.Google Scholar
Hurxthal, L. M. & O'Sullivan, J. B. (1959) Cushing's Syndrome: clinical differential diagnosis and complications. Annals of Internal Medicine, 51, 116.Google ScholarPubMed
Joplin, G. F., Fraser, T. R., Hill, D., Oakley, N., Scott, D. & Doyle, F. H. (1965) Pituitary ablation for diabetic retinopathy. Quarterly Journal of Medicine, 34, 443–62.Google Scholar
Kelly, W. F., Mashiter, K., Doyle, F. H., Banks, L. M., & Joplin, G. F. (1978) Treatment of prolactin-secreting pituitary tumours in young women by needle implantation of radioactive yttrium. Quarterly Journal of Medicine, 47, 473–93.Google Scholar
Kiely, M. & Sourkes, T. L. (1972) Transport of 1-tryptophan into slices of rat cerebral cortex. Journal of Neurochemistry, 19, 2863–72.Google Scholar
Knox, W. E. & Auerbach, V. H. (1955) The hormonal control of tryptophan peroxidase in the rat. Journal of Biological Chemistry, 214, 307–13.Google Scholar
Knott, P. J. & Curzon, G. (1972) Free tryptophan in plasma and brain tryptophan metabolism. Nature, 239, 452–3.Google Scholar
Maeda, M. & Tsuji, A. (1973) A fluorophotometric method for the detection of amino acids using pyridoxal and zinc ion. Analytic Biochemistry, 52, 555–62.Google Scholar
Maguire, G. P., Julier, D. L., Hawton, K. E. & Bancroft, J. H. (1974) Psychiatric morbidity and referral in two general medical wards. British Medical Journal, i, 268–70.Google Scholar
Moffic, S. C. & Paykel, E. S. (1975) Depression in medical In-Patients. British Journal of Psychiatry, 126, 346–53.Google Scholar
McMenamy, R. H. & Oncley, J. L. (1958) The specific binding of 1-tryptophan to serum albumin. Journal of Biological Chemistry, 233, 1436–47.Google Scholar
Nakai, Y., Nakao, K., Oki, S., Immura, H. & Li, C. H. (1978) Presence of immunoreactive β-endorphin in plasma of patients with Nelson's Syndrome and Addison's disease. Lift Sciences, 23, 2293–8.Google Scholar
Pardridge, W. M. (1977) Kinetics of competitive inhibition of neutral amino acid transport across the blood brain barrier. Journal of Neurochemistry, 28, 103–8.Google Scholar
Schwab, J. J., Bialow, M., Clemmons, R., Martin, P. & Holzer, C. E. (1967) The Beck Depression Inventory with medical In-patients. Acta Psychiatrica Scandinavica, 43, 255–66.Google Scholar
Smyth, D. G. (1978) The common prohormone of corticotrophin and the opiate peptide lipotrophin C-fragment (beta-endorphin). Biochemical Society Transactions, 6, 61–3.CrossRefGoogle Scholar
Spillane, J. D. (1951) Nervous and mental disorders in Cushing's Syndrome. Brain, 74, 7294.CrossRefGoogle ScholarPubMed
Stewart, M. A., Drake, I. & Winokur, G. (1965) Depression among medically ill patients. Diseases of the Nervous System, 26, 479–85.Google ScholarPubMed
Tagliamonte, A., Biggio, G., Vargiu, L. & Gessa, G. L. (1973) Increase of brain tryptophan and stimulation of serotonin synthesis by salicylate. Journal of Neurochemistry, 20, 909–12.Google Scholar
Trethowan, W. H. & Cobb, S. (1952) Neuropsychiatric aspects of Cushing's Syndrome. Archives of Neurology and Psychiatry, 67, 283309.CrossRefGoogle ScholarPubMed
Van Praag, H. M. (1979) Central serotonin metabolism and vulnerability for affective disorders. Acta Psychiatrica Scandinavica (in press).Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.