Document Detail

Patients with carcinoid syndrome exhibit symptoms of aggressive impulse dysregulation.
MedLine Citation:
PMID:  15184706     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Carcinoid tumors can produce excessive amounts of biogenic amines, notably serotonin. We assessed psychiatric symptoms in carcinoid patients and peripheral metabolism of tryptophan, the precursor of serotonin. METHODS: Twenty consecutive patients with carcinoid syndrome underwent a structured psychiatric interview applying DSM-IV (Diagnostical Statistical Manual) criteria. Tumor activity was measured by determination of 24-hour urine excretion of 5-hydroxyindoleacetic acid (5-HIAA) and platelet serotonin levels. Plasma tryptophan levels were measured and compared with sex- and age-matched references. RESULTS: Fifteen patients (75%) fulfilled diagnostic DSM-IV criteria for a disorder of impulse control. Tryptophan plasma levels were lower in patients compared with controls (p =.031) and were correlated negatively with urinary 5-HIAA excretion (p =.001). CONCLUSIONS: Impulse control disorders are prevalent in patients with carcinoid syndrome. The serotonin production by the tumor possibly decreases the tryptophan pool in the cerebrospinal fluid, which is the essential substrate for the production of brain serotonin as a pivotal neurotransmitter.
Sascha Russo; Jim C Boon; Ido P Kema; Pax H B Willemse; Johan A den Boer; Jakob Korf; Elisabeth G E de Vries
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Psychosomatic medicine     Volume:  66     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:    2004 May-Jun
Date Detail:
Created Date:  2004-06-08     Completed Date:  2004-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-5     Citation Subset:  IM    
Department of Biological Psychiatry, University Hospital Groningen, The Netherlands.
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MeSH Terms
Aggression / psychology*
Blood Platelets / chemistry,  metabolism
Carcinoid Tumor / diagnosis,  metabolism,  psychology*
Diagnostic and Statistical Manual of Mental Disorders
Hydroxyindoleacetic Acid / urine
Impulse Control Disorders / diagnosis*,  metabolism,  psychology
Middle Aged
Personality Disorders / diagnosis,  metabolism,  psychology
Psychiatric Status Rating Scales
Serotonin / biosynthesis,  blood,  physiology
Tryptophan / blood,  cerebrospinal fluid,  metabolism
Reg. No./Substance:
50-67-9/Serotonin; 54-16-0/Hydroxyindoleacetic Acid; 73-22-3/Tryptophan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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