MONOAMINE ACTIVITY REFLECTED IN URINE OF YOUNG-PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER, PSYCHOSIS WITH AND WITHOUT REALITY DISTORTION AND HEALTHY-SUBJECTS - AN EXPLORATIVE ANALYSIS

Positive psychotic symptoms are reported to be associated with high, n egative symptoms with low dopamine (DA) activity and serotonin (5HT) a ctivity may be altered in obsessive-compulsive disorder (OCD). We anal ysed 24 h urine samples in these patient groups and in healthy control s for supportive evidence. Young unmedicated OCD subjects excreted mor e adrenaline (AD) and homovanillic acid (HVA) and showed a higher HVA/ MHPG ratio and metabolic rate than healthy controls. Independent of ge neral metabolic rate they showed higher HVA concentrations which sugge sts that the relative activity of catecholamine systems in OCD (HVA/MH PG) is due more to high DA than to low noradrenergic (NA) activity. Co ncentrations of 5HT were also high in OCD patients. In psychotic patie nts low levels of DA, HVA, NA and MHPG probably resulted from neurolep tic medication. Patients diagnosed with paranoid psychosis showed high er DA utilization than controls and those with few paranoid symptoms s howed high 5HT utilization. These results support studies suggesting t hat paranoid psychosis is associated more with increased DA activity ( discussed in the context of neuroleptic reactivity), that non-paranoid forms are associated more with increased 5HT activity and that OCD pa tients are unusually aroused with high levels of Ad, 5HT and HVA.