Am J Psychiatry 1991; 148:240-243
Copyright © 1991 by American Psychiatric Association
Characteristics of psychotic inpatients with high or low HVA levels at admission
MB Bowers Jr
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519.
OBJECTIVE: The purpose of this study was to examine the clinical profiles
of psychotic patients whose fasting levels of plasma free homovanillic acid
(HVA) were elevated on the day after admission to the hospital. METHOD:
These 85 subjects with nonorganic psychoses had been previously studied
with respect to their response to neuroleptic treatment. They were divided
into two groups on the basis of a median split of their pretreatment plasma
HVA levels, and the two groups were compared on a number of clinical and
demographic variables ascertained during their hospital stay. Fasting
levels of plasma free HVA and 3- methoxy-4-hydroxyphenylglycol (MHPG) were
measured by gas chromatography-mass spectrometry. RESULTS: The high-HVA
group tended to show a better prognostic profile than the low-HVA group;
however, the only significant difference between groups was in the greater
use of psychotogenic drugs by low-HVA males. Fourteen additional psychotic
patients with distinctly elevated HVA levels and normal MHPG values were
also diagnostically heterogeneous. CONCLUSIONS: The results suggest that
psychotic patients with different diagnoses who have relatively high levels
of plasma free HVA before treatment will show a favorable early response to
neuroleptic drugs. There may be neurobiological processes linking some
patients across the clinical spectrum of the psychotic disorders.
