Electrolytes Metabolism in Blood and Cerebrospinal Fluid in Psychoses

Abstract

Summary Measurements were performed on Na, K and Ca contents with flame‐photometer, and on CI content with electro‐photometer both in serum of 464 cases (frequency of examinations was 1.077 times) of various psychotics (mainly consisted of schizophrenics) and in cerebrospinal fluid of 303 cases (frequsncy of examinations 909 times). Following results were obtained. 1. In schizophrenia, as a whole, Na, K, Ca and CI contents both in serum and CSF were almost within normal limits, but only K in CSF was increased, so the Na/K decreased as compared with those in the normal group. Comparison between the diseased and improved periods showed that Na and K in serum had tendencies to decrease, while Na and CI in CSF increased in the improved period, thereby the decrease of K in CSF was marked. 2. Under the classification of schizophrenia into hebephrenia and catatonia, it proved that both types exhibited almost the same inclinations as mentioned above. Moreover, comparison between the fresh and chronic groups of schizophrenia as a whole revealed that, in the fresh group there were observed the decrease of Na and CI and the increase of Ca in serum, and the decrease of K and increase of Na/K in CSF in the course of improvement, while in the chronic group, there were the decrease of Na in serum, the decrease of K and Ca in CSF, and increase of Na/K in CSF in the course of convalescence. On the contrary, in the unchanging group, variations of electrolytes were hardly observable both in serum and CSF. 3. In the comparison between the fresh and chronic groups in each type of schizophrenia, both groups displayed almost identical trends, thereby most marked was the increase of K in CSF in the diseased period. Moreover, in CSF, Na contents were decreased in the fresh groups of both types of schizophrenia, CI increased in fresh hebephrenia, and Ca decreased in chronic catatonia. As the result of comparison between the fresh and chronic cases, it proved that, in hebephrenia, Na and Na/K in CSF increased more but K and Ca in CSF decreased more in the chronic cases than in the fresh ones; while, in catatonia, K in serum increased more in the chronic cases. 4. Schizophrenia was, furthermore, divided tentatively into 6 groups according to the symptoms, and comparisons of these groups proved that Na both in serum and in CSF tended to decrease but CI slightly increased under the hypo‐and akinesis, while K in CSF increased in case of marked emotional changes. 5. In the chronic schizophrenics hospitalized for a long time, both Na and K in serum and CSF were within normal sphere, and there were observed almost the same inclinations as mentioned above, in the results of the frequent examinations made in the course of time, some on the same cases of this group. 6. In the other various psychotics, each value was almost within normal range, although the cases were few in number. Mania displayed almost identical tendency in electrolytes variations, but depression displayed somewhat different inclinations where Na in CSF was decreased. As for gener...

CSF biochemical correlates of mixed affective states

“…Several studies of electrolyte (principally the cations sodium, potassium, calcium and magnesium) metabolism in affective disorders also have been conducted, with inconclusive results. While normal conditions appear to be the general rule (43), decreased CSF sodium levels in depression compared with mania were reported in one study (44).…”

CSF biochemical correlates of mixed affective states

“…Several studies of electrolyte (principally the cations sodium, potassium, calcium and magnesium) metabolism in affective disorders also have been conducted, with inconclusive results. While normal conditions appear to be the general rule (43), decreased CSF sodium levels in depression compared with mania were reported in one study (44).…”

Increased Serum Calcium and Phosphorus with the ‘Switch’ into Manic or Excited Psychotic States

“…This report summarizes results of longitudinal determinations of serum calcium and phos phorus in a group of psychotic in-patients undergoing repeated episodes of acute psychotic agitation. The considerations which prompted this study, reviewed in detail elsewhere (Carman and Wyatt, 1977;Carman et al, 1974 and1977;Jimerson et al, 1976), include: (a) periodic psychoses with paramount affective or catatonic symptoms are occasional complications of primary disorders of calcium metabolism, and psychiatric symptoms commonly abate following medical or surgical restoration of normal calcium balance; (b) experimental reduction of CSF calcium concentration in animals pro duces hyperactivity, hyper-irritability, hyper sexuality, insomnia, and anorexia, while in creases in CSF calcium are associated with hypersomnia, hypoactivity, and lethargy; (c) on a neuronal level, reductions of extracellular calcium could account for several of the alterations in central neuronal function, either postulated or demonstrated in mania; (d) decreases in CSF calcium concentration are noted with antidepressant responses to ECT (Carman et al, 1977); (e) CSF calcium is lower during manic than depressed phases in manic depressive patients subject to rapid cycles of illness (Carman and Wyatt, 1977;Carman et a!, 1974;Jimerson et al, 1976; Weston and Howard 1922) and lower in catatonic excitement than stupor (Ueno et a!, 1961); (f) increases in the concentrations of serum total calcium have been reported during both spontaneous or drug induced switches into mania or catatonic excitement (Carman et al, 1974;Weston and Howard, 1922;Ueno et al, 1961;Henry and Ebeling, 1925;Speijer, 1950;Fischback, 1971). The present study examines whether recurrent onsets of excited psychotic states are accom panied by alterations in calcium and related serum parameters.…”

“…Abrupt phase shifts in circadian rhythms of several physiochemical parameters have been described at the time of the switch (Wehr and Goodwin, 1975). Since, in normals the range of circadian variation in both serum total calcium and serum inorganic phosphorus would be sufficient to account for the majority of the (Carman and Wyatt, 1977;Carman et al, 1974;Jimerson et al, 1976;Weston and Howard, 1922;Ueno et al, 1961), perhaps by release of calcitonin (Stecol nikov, 1969) suppression of the parathyroids (Merritt and Bauer, 1931), or some other process.…”

CSF biochemical correlates of mixed affective states

“…Several studies of electrolyte (principally the cations sodium, potassium, calcium and magnesium) metabolism in affective disorders also have been conducted, with inconclusive results. While normal conditions appear to be the general rule (43), decreased CSF sodium levels in depression compared with mania were reported in one study (44).…”

Increased Serum Calcium and Phosphorus with the ‘Switch’ into Manic or Excited Psychotic States

“…This report summarizes results of longitudinal determinations of serum calcium and phos phorus in a group of psychotic in-patients undergoing repeated episodes of acute psychotic agitation. The considerations which prompted this study, reviewed in detail elsewhere (Carman and Wyatt, 1977;Carman et al, 1974 and1977;Jimerson et al, 1976), include: (a) periodic psychoses with paramount affective or catatonic symptoms are occasional complications of primary disorders of calcium metabolism, and psychiatric symptoms commonly abate following medical or surgical restoration of normal calcium balance; (b) experimental reduction of CSF calcium concentration in animals pro duces hyperactivity, hyper-irritability, hyper sexuality, insomnia, and anorexia, while in creases in CSF calcium are associated with hypersomnia, hypoactivity, and lethargy; (c) on a neuronal level, reductions of extracellular calcium could account for several of the alterations in central neuronal function, either postulated or demonstrated in mania; (d) decreases in CSF calcium concentration are noted with antidepressant responses to ECT (Carman et al, 1977); (e) CSF calcium is lower during manic than depressed phases in manic depressive patients subject to rapid cycles of illness (Carman and Wyatt, 1977;Carman et a!, 1974;Jimerson et al, 1976; Weston and Howard 1922) and lower in catatonic excitement than stupor (Ueno et a!, 1961); (f) increases in the concentrations of serum total calcium have been reported during both spontaneous or drug induced switches into mania or catatonic excitement (Carman et al, 1974;Weston and Howard, 1922;Ueno et al, 1961;Henry and Ebeling, 1925;Speijer, 1950;Fischback, 1971). The present study examines whether recurrent onsets of excited psychotic states are accom panied by alterations in calcium and related serum parameters.…”

“…Abrupt phase shifts in circadian rhythms of several physiochemical parameters have been described at the time of the switch (Wehr and Goodwin, 1975). Since, in normals the range of circadian variation in both serum total calcium and serum inorganic phosphorus would be sufficient to account for the majority of the (Carman and Wyatt, 1977;Carman et al, 1974;Jimerson et al, 1976;Weston and Howard, 1922;Ueno et al, 1961), perhaps by release of calcitonin (Stecol nikov, 1969) suppression of the parathyroids (Merritt and Bauer, 1931), or some other process.…”

CSF biochemical correlates of mixed affective states

“…Several studies of electrolyte (principally the cations sodium, potassium, calcium and magnesium) metabolism in affective disorders also have been conducted, with inconclusive results. While normal conditions appear to be the general rule (43), decreased CSF sodium levels in depression compared with mania were reported in one study (44).…”

Increased Serum Calcium and Phosphorus with the ‘Switch’ into Manic or Excited Psychotic States

“…This report summarizes results of longitudinal determinations of serum calcium and phos phorus in a group of psychotic in-patients undergoing repeated episodes of acute psychotic agitation. The considerations which prompted this study, reviewed in detail elsewhere (Carman and Wyatt, 1977;Carman et al, 1974 and1977;Jimerson et al, 1976), include: (a) periodic psychoses with paramount affective or catatonic symptoms are occasional complications of primary disorders of calcium metabolism, and psychiatric symptoms commonly abate following medical or surgical restoration of normal calcium balance; (b) experimental reduction of CSF calcium concentration in animals pro duces hyperactivity, hyper-irritability, hyper sexuality, insomnia, and anorexia, while in creases in CSF calcium are associated with hypersomnia, hypoactivity, and lethargy; (c) on a neuronal level, reductions of extracellular calcium could account for several of the alterations in central neuronal function, either postulated or demonstrated in mania; (d) decreases in CSF calcium concentration are noted with antidepressant responses to ECT (Carman et al, 1977); (e) CSF calcium is lower during manic than depressed phases in manic depressive patients subject to rapid cycles of illness (Carman and Wyatt, 1977;Carman et a!, 1974;Jimerson et al, 1976; Weston and Howard 1922) and lower in catatonic excitement than stupor (Ueno et a!, 1961); (f) increases in the concentrations of serum total calcium have been reported during both spontaneous or drug induced switches into mania or catatonic excitement (Carman et al, 1974;Weston and Howard, 1922;Ueno et al, 1961;Henry and Ebeling, 1925;Speijer, 1950;Fischback, 1971). The present study examines whether recurrent onsets of excited psychotic states are accom panied by alterations in calcium and related serum parameters.…”

“…Abrupt phase shifts in circadian rhythms of several physiochemical parameters have been described at the time of the switch (Wehr and Goodwin, 1975). Since, in normals the range of circadian variation in both serum total calcium and serum inorganic phosphorus would be sufficient to account for the majority of the (Carman and Wyatt, 1977;Carman et al, 1974;Jimerson et al, 1976;Weston and Howard, 1922;Ueno et al, 1961), perhaps by release of calcitonin (Stecol nikov, 1969) suppression of the parathyroids (Merritt and Bauer, 1931), or some other process.…”