우울증 환자의 혈당에 관한 연구

A STUDY OF FASTING BLOOD SUGAR IN DEPRESSION

In the biochemical study of depression, research interest has been focused mainly on the metabolism of neurotransmitters. Meanwhile, several researchers have paid attention to the blood sugar change in depression. Pryce (1958), van-P raag (1965), Muller, Heninger & McDonald (1969) and Diebold (1976) proved th a t blood sugar level was increased during active phase of depression and decreased by recovery, while, Herzberg, Coppen & Marks (1968) reported opposite result. The authors have tried to confirm the changes of blood sugar in depression with special regard to patterns of the changes in diagnostic subgroups of depression. Fifty six in-patients were initiallyselected for the study. But out of 56 subjeets, 22 were discarded； 12 subjects were lost because of their early discharge, two cass of thyroid dysfunction, two of diabetes mellitusarid 6 with history of antidepressant m edication previously at the out-patient clinic were excluded in this study. Among 34 subjects, 16 were retarded depression, 5 were agitated depression and 13 were secondary depreession which was observed in borderline and hysterical personality disorders and recovered schizophrenia. Fasting blood sugar level was checked on the first, th ird , fifth days of admission, then weekly basis till fifth week. Hamilto ns Rationg Scale for depression was used in symptom evaluation on the days of blood sampling. Fasting blood sugar level of retarded depression was higher than that of secondary depression. However, this increase was within normal limit. On the other, two subgroups could be identified according to the p attern of blood sugar level； typical and atypical groups. Typical group was a state in which manifested increased FBS level in the initial phase of treatment then slow decrease as symptom improvement. Atypical group was a state in which manifested irregular FBS level on the course of illness without inital increase. Fifty percent of retarded depression, 20 percent of agitated depression, and 15.4 percent of secondary depression were the typical group. The amount of food intake revealed no difference between the typical and atypical groups. According to factor analysis of Hamilton’s rating scale, factor I, Insomnia, was more prominent in typical group and factor V，Somatic Delusion, in atypical group. Symptom improvem ent was faster intypical group for 6 days than atypicl group. Tricyclic antidepressant and phenothiazine seemed to have no effect on the FBS level. In the typical group, the increased FBS decreased gradually and maintained steady level in one to two weeks, and symptom improvement was followed six to thirteen days later.