The Relationship Between Glucose Tolerance, Body Weight, and Clinical State in Melancholia

Abstract

In a recent investigation the present author has shown that glucose tolerance (G.T.) was significantly lower in a group of middle-aged mental hospital patients suffering from severe depression, than in a non-psychiatric group of similar age distribution (Pryce, 1958). This observation is similar to many others reported earlier (see review by McFarland and Goldstein, 1939). The cause of this impairment of G.T. is unknown; it cannot be explained by defective absorption of glucose from the alimentary canal since an intravenous G.T. test was employed in the investigation mentioned. Again, defective dietary intake during the days before testing could have contributed to the decreased G.T. in only a few cases; there was also no correlation between G.T. and either general symptomatology or the patients' behaviour during testing. However, it was observed that the group of depressions weighed significantly less than the control group, though again no correlation was found between body weight and G.T. among the depressions themselves. McCowan and Quastel (1931) and others have reported a close parallel between decreased G.T. and “emotional tension”, evidence which favours an emotional cause for the phenomenon, in line with the theories of W. B. Cannon (1911).

Impaired Glucose Tolerance in Long-Term Lithium-Treated Patients

“…Previous studies on the oGTT in patients with mental disorders show distur bances of carbohydrate metabolism primarily during acute endogenousdepressive episodes compared to the 'free interval' (Pryce, 1958 In conclusion, we consider the present findings to show an increase in the frequency of impaired glucose tolerance in manic-depressive and schizo-affective patients under long-term lithium treatment. It is, however, unlikely that the impairment is a primary and direct effect of lithium.…”