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Tryptophan, Cortisol and Puerperal Mood

Published online by Cambridge University Press:  29 January 2018

S. L. Handley
Affiliation:
Department of Pharmacy, University of Aston, Gosta Green, Birmingham B4 7ET
T. L. Dunn
Affiliation:
Walsgrave Hospital, Coventry
G. Waldron*
Affiliation:
Walsgrave Hospital, Coventry
J. M. Baker*
Affiliation:
Department of Pharmacy, University of Aston
*
Present Address: Department of Psychiatry, The London Hospital Medical College, London E1.
Present Address: Faculty of Pharmacy and Pharmaceutical Sciences, The University of Alberta, Edmonton, Alberta, Canada.

Summary

Plasma Cortisol, free and total tryptophan were determined in 71 subjects on 8 occasions between 36 weeks gestation and 6 weeks post-partum. Affect was measured by rating scales and clinical interview. Twenty-eight subjects were judged to have experienced post-partum ‘blues'. Seasonal variation occurred in the incidence of ‘blues' and in Cortisol and free tryptophan levels. Puerperally-depressed mood was correlated with high Cortisol at 38 weeks irrespective of season. Free tryptophan was reduced in ‘blues' subjects but only at the time of year when free tryptophan was normally high. Total tryptophan was low antenatally; a rapid rise on days 1 and 2 post-partum was superimposed on a slower return to normal. This initial peak was clearly absent in 37 per cent of subjects. Its absence was significantly related to occurrence of post-partum ‘blues' and of complaints of depression in the ensuing 6 months. This finding is discussed in relation to the possible occurrence of an occult disturbance of tryptophan handling in subjects susceptible to depression.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Ahjua, M. S. & Sharma, N. J. (1971) Adrenocortical function in relation to seasonal variations in normal Indians. Indian Journal of Medical Research, 59, 18931905.Google Scholar
Aylward, M. & Maddock, J. (1973) Plasma-tryptophan levels in depression. Lancet, i, 936.CrossRefGoogle Scholar
Aylward, M. (1976) Estrogens, plasma tryptophan levels in perimenopausal patients. In The Management of the Menopause and Post-menopausal Years. (ed. Campbell, S.). Baltimore: Univ. Park. pp 135–47.Google Scholar
Batra, S. & Grundsell, H. (1978) Studies on certain aspects of progesterone and Cortisol dynamics before, during and after labour. Clinical Endocrinology, 8, 403–9.CrossRefGoogle ScholarPubMed
Beck, A., Ward, C., Mendelson, M., Mock, J. & Erbaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–71.CrossRefGoogle ScholarPubMed
Bender, D. A., Boulton, A. P. & Coulson, W. J. (1975) A simple method for the study of tryptophan binding to serum albumin by small scale equilibrium dialysis: application to animal and human studies. Biochemistry Society Transactions, 3, 193–4.CrossRefGoogle Scholar
Bloxam, D. L. & Warren, W. H. (1974) Error in the determination of tryptophan by the method of Denkla and Dewey. A revised procedure. Analytical Biochemistry, 60, 621–5.CrossRefGoogle Scholar
Board, F., Wadeson, R. & Persky, H. (1957) Depressive affect and endocrine functions. Archives of Neurological Psychiatry, 28, 612–20.Google Scholar
Bonham-Carter, S., Sandler, M., Goodwin, B. L., Sepping, P. & Bridges, P. K. (1978) Decreased urinary output of tyramine and its metabolites in depression. British Journal of Psychiatry, 132, 125–32.Google Scholar
Bunney, W. E., Mason, J. W. & Hamburg, D. A. (1965) Correlations between behavioural variables and urinary 17-hydroxycorticosteroids in depressed patients. Psychosomatic Medicine, 27, 299308.CrossRefGoogle ScholarPubMed
Christensen, H. N. (1975) Biological Transport. New York: Benjamin.Google Scholar
Coppen, A., Eccleston, E. G. & Peet, M. (1972) Total and free tryptophan concentration in the plasma of depressive patients. Lancet, ii, 1415–16.Google Scholar
Coppen, A., Eccleston, E. G. & Peet, M. (1973) Total and free tryptophan concentration in the plasma of depressive patients. Lancet, ii, 60–3.Google Scholar
Coppen, A., Brooksbank, B. W. L., Eccleston, E., Peet, M. & White, S. G. (1974) Tryptophan metabolism in depressive illness. Psychological Medicine, 4, 164–73.CrossRefGoogle ScholarPubMed
Coppen, A. & Wood, K. (1978) Tryptophan and depressive illness. Psychological Medicine, 8, 4957.CrossRefGoogle ScholarPubMed
Cox, B. D. & Calame, D. P. (1978) Changes in plasma amino-acid levels during the human menstrual cycle and in early pregnancy. A preliminary report. Hormone and Metabolic Research, 10, 428–33.CrossRefGoogle ScholarPubMed
Dalton, K. (1971) Prospective study of puerperal depression. British Journal of Psychiatry, 118, 689–92.CrossRefGoogle ScholarPubMed
Denkla, W. D. & Dewey, H. K. (1967) The determination of tryptophan in plasma, liver and urine. Journal of Laboratory and Clinical Medicine, 69, 160–9.Google Scholar
Garfinkel, P. E., Warsh, J. J., Stancer, H. C. & Sibony, D. (1976) Total and free plasma tryptophan levels in patients with affective disorders. Archives of General Psychiatry, 33, 1462–6.CrossRefGoogle ScholarPubMed
Giordano, N. D. & Radivoyevitch, M. (1970) Seasonal variations of plasma Cortisol in haemophilia-A. Lancet, i, 249.CrossRefGoogle Scholar
Green, A. R. & Grahame-Smith, D. G. (1976) Effects of drugs on the processes regulating the functional activity of brain 5-hydroxytryptamine. Nature, 260, 487–91.Google ScholarPubMed
Hamilton, J. A. (1962) Post-partum Psychiatric Problems. St Louis: C. V. Mosby.Google Scholar
Handley, S. L., Dunn, T. L., Baker, J. M., Cockshott, C. & Gould, S. E. (1977) Mood changes in puerperium and plasma tryptophan and Cortisol concentrations. British Medical Journal, ii, 1822.CrossRefGoogle Scholar
Jolivet, A., Blanchier, B. & Gautray, J. P. (1974) Blood Cortisol variations during late pregnancy and labour. American Journal of Obstetrics and Gynecology, 119, 775–83.CrossRefGoogle Scholar
Kendell, R. E., Wainwright, S., Hailey, A. & Shannon, B. (1976) Influence of childbirth on psychiatric morbidity. Psychological Medicine, 6, 297302.CrossRefGoogle ScholarPubMed
Kishimoto, H. & Hama, Y. (1976) The level and diurnal rhythm of plasma tryptophan and tyrosine in manic-depressive patients. Yokohama Medical Bulletin, 27, 8997.Google Scholar
McMenamy, R. H. & Oncley, J. L. (1958) The specific binding of l-tryptophan to serum albumin. Journal of Biological Chemistry, 233, 1436–47.CrossRefGoogle ScholarPubMed
Mattingley, D. (1962) A simple fluorimetric method for the estimation of 11-hydroxycorticosteroids in human plasma. Journal of Clinical Pathology, 15, 374–9.Google Scholar
Møller, S. E., Kirk, L. & Fremming, K. H. (1976) Plasma amino acids as an index for subgroups in manic depressive psychosis-correlation to effect of tryptophan. Psychopharmacology, 49, 205–13.CrossRefGoogle ScholarPubMed
Møller, S. E., Kirk, L. & Honoré, P. (1979) Free and total tryptophan in endogenous depression. Journal of Affective Disorders, 1, 6976.CrossRefGoogle ScholarPubMed
Nie, N. H., Hull, C. H., Jenkins, J. G., Steinbrenner, K. & Bent, D. H. (1975) Statistical Package for the Social Sciences. New York: McGraw-Hill.Google Scholar
Niskanen, P., Huttunen, M., Tamminen, T. & Jääskeläinen, J. (1976) The daily rhythm of plasma tryptophan and tyrosine in depression. British Journal of Psychiatry, 128, 6773.CrossRefGoogle ScholarPubMed
Nott, P. N., Franklin, M., Armitage, C. & Gelder, M. G. (1976) Hormonal changes and mood in the puerperium. British Journal of Psychiatry, 128, 379–83.CrossRefGoogle ScholarPubMed
Ohrlander, S., Gennser, G. & Eneroth, P. (1976) Plasma Cortisol levels in human fetus during parturition. Obstetrics and Gynecology, 48, 381–7.Google ScholarPubMed
Okada, D. M., Tulchinsky, D., Ross, J. W. & Hobel, C. J. (1974) Plasma estrone, estradiol, estriol, progesterone and Cortisol in normal labor. American Journal of Obstetrics and Gynecology, 119, 502–7.CrossRefGoogle ScholarPubMed
Oppenheim, G. (1962) Psychological aspects of pregnancy and childbirth. Lecture to the R.M.P.A., London. Quoted by Pitt (1966).Google Scholar
Pardridge, W. M. (1977) Kinetics of competitive inhibition of neutral amino acid transport across the blood-brain barrier. Journal of Neurochemistry, 28, 103–8.CrossRefGoogle ScholarPubMed
Peet, M., Moody, J. P., Worrall, E. P., Walker, P. & Naylor, G. J. (1976) Plasma tryptophan concentration in depressive illness and mania. British Journal of Psychiatry, 128, 255–8.CrossRefGoogle ScholarPubMed
Phillip, B. A. & Hanson, K. H. (1974) Circannual cycles in morning Cortisol levels in man in Fairbanks, Alaska. In Chronobiology. (eds. Scheving, L. E., Halberg, M. D. and Pauly, J. E.). Stuttgart, Thieme, pp 256–61.Google Scholar
Pichot, J., Piret, J. & Clyde, D. J. (1966) (Factorial analysis of symptoms of depression). Revue de Psychologie Appliquée, 16, 105–15.Google Scholar
Pitt, B. M. N. (1966) A Study of Emotional Disturbance Associated with Child Bearing. M. D. Thesis, University of London.Google Scholar
Pitt, B. M. N. (1973) Maternity blues. British Journal of Psychiatry, 122, 431–3.CrossRefGoogle ScholarPubMed
Pugh, T. G., Jerath, B. K., Schmidt, W. M. & Reed, R. B. (1963) Rates of mental disease related to child bearing. New England Journal of Medicine, 268, 1224–8.CrossRefGoogle Scholar
Riley, G. J. & Shaw, D. M. (1976) Total and non-bound tryptophan in unipolar illness. Lancet, ii, 1249.CrossRefGoogle Scholar
Robin, A. M. (1962) Psychological changes of normal parturition. Psychiatric Quarterly, 36, 129–50.CrossRefGoogle ScholarPubMed
Sachar, E. J. (1967) Corticosteroids in depressive illness II. A longitudinal psychoendocrine study. Archives of General Psychiatry, 17, 554–67.CrossRefGoogle Scholar
Sachar, E. J., Hellman, L., Roffwarg, H. P., Halpern, E. S., Fukushima, D. K. & Gallagher, T. F. (1973) Disrupted 24 hour pattern of Cortisol secretion in psychotic depression. Archives of General Psychiatry, 28, 1924.CrossRefGoogle ScholarPubMed
Shaw, D. M., Johnson, A. L., Tidmarsh, S. F., Mac-Sweeney, D. A., Hewland, H. R. & Woolcock, N. E. (1975) Multi-compartmental analysis of amino acids: 1. Preliminary data on concentrations, fluxes and flow constants of tryptophan in affective illness. Psychological Medicine, 5, 206–13.CrossRefGoogle Scholar
Siegel, S. (1956) Nonparametric Statistics for the Behavioural Sciences. Tokyo: McGraw-Hill Kogakusha.Google Scholar
Spano, P. F., Andreoli, V., Tonon, G. C. & Sirtori, C. R. (1975) Plasma tryptophan transport in normal and depressed subjects. Medical Biology, 53, 489–92.Google ScholarPubMed
Stein, G., Milton, F., Bebbington, P., Wood, K. & Coppen, A. (1976) Relationship between mood disturbances and free and total plasma tryptophan in post-partum women. British Medical Journal, ii, 457.CrossRefGoogle Scholar
Stengel, E. (1969) Suicide and Attempted Suicide. London: Penguin.Google Scholar
Swinscow, D. (1951) Some suicide statistics. British Medical Journal, i, 1417–23.Google Scholar
Yalom, I., Lunde, D., Moos, R. & Hamburg, D. (1968) ‘Post-partum blues’ syndrome. Archives of General Psychiatry. 18, 1627.CrossRefGoogle ScholarPubMed
Young, M. & Prenton, M. A. (1969) Maternal and fetal amino acid concentrations during gestation and in retarded fetal growth. Journal of Obstetrics and Gynaecology of the British Commonwealth, 76, 333–4.CrossRefGoogle ScholarPubMed
Yuwiler, A., Oldendorf, W. H., Geller, F. & Brain, L. (1977) Effect of albumin binding and amino acid competition on tryptophan uptake into brain. Journal of Neurochemistry, 28, 1015–23.CrossRefGoogle ScholarPubMed
Zuckerman, M. & Lubin, B. (1965) Manual for the Multiple Affect Adjective Check-list. Educational and Industrial Testing Service, San Diego, California.Google Scholar
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