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Date: | Tue, 24 Jan 2006 15:38:07 -0600 |
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TI: AFFECTIVE AND ATOPIC DISORDERS AND CYCLIC AMP
AU: OSSOFSKY-H-J [Author]
SO: Comprehensive-Psychiatry. 1976; 17(2): 335-346
PY: 1976
DT: Article
IS: 0010-440X
AB: To test the hypothesis that the affective state itself might be
associated with atopic reaction, depressed children and adults
referred for psychiatric evaluation between July 1972-July 1973 were
referred for allergic evaluation irrespective of the presence of
allergic signs or symptoms. Of 109 depressed patients evaluated, 93
proved atopic. Of 3 nonatopic children, 2 developed positive skin
reactions to testing, 4 and 8 mo. after being placed on imipramine
therapy. Despite absence or paucity of allergic symptoms in about
half of the atopic individuals, all 93 atopic patients were treated
by routine techniques, including environmental control and
desensitization. The affective disorder was treated concomitantly
with imipramine HCl or, in a few adults, with desipramine HCl. As
depression was relieved, several children developed allergic
respiratory symptoms for the first time, despite immunotherapy.
Allergic symptoms were relieved by increasing the strength of vaccine
and/or decreasing the time interval between injections. The children
showed frequent seasonal exacerbations of allergic symptoms
independent of exacerbations of depression. Those receiving
successful immunization seemed to respond considerably better than
nonimmunized children; maintenance doses of imipramine tended to be
significantly smaller and could be discontinued for longer intervals.
The intimate relationship of allergy and depression suggested that an
abnormality in a neurotransmitter and/or the hypothalamic
pituitary-target-organ axis might be common to both clinical
conditions. Hormonal functions mediated by the ATPase system
(cyclic[c]AMP involvement in adrenal and thyroid hormonal systems)
are discussed. A defect in cAMP, its precursors, its degradation
products or its turnover probably accounts for the variation in
steroid excretion patterns of depressed patients. The therapeutic
effectiveness of compounds as dissimilar as thyroid hormone(s) and
imipramine in the treatment of depression is discussed. Irritability
and hyperactivity of the depressed child may be related to Ca and/or
thyroid-provoked cAMP activity; enuresis and premenstrual fluid
retention noted in some depressed children and adults are probably
due to actions of Ca, aldosterone, angiotensin II and Na and K
influences on the cAMP system. Several effects of cAMP dysfunction
are discussed. Probing normal and abnormal cAMP activity may clarify
the relationship between affective disorders and other illnesses such
as ulcerative colitis, gastric and duodenal ulcers, rheumatoid
arthritis, myasthenia gravis and migraine.
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