CSF biochemical correlates of mixed affective states

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Abstract
To evaluate the question of whether "mixed" bipolar disorder is a distinct entity, we compared selectedcerebrospinal fluid (CSF) biochemical parameters from patients with bipolar disorder, mixed, to those with mania and major depression. Fourteen patients in each category (DSM-III) were studied with regard to CSF HVA, 5HIAA, sodium, potassium, calcium, and magnesium levels under carefully controlled conditions. CSF HVA, 5HIAA, and sodium were found to be significantly higher in manics than in major depressives. Discriminant analysis of the biocheimcal variables of the mixed affective group identified two biocheimcally distinct and clinically different subgroups of seven patients each, one resembling the manic group and the other the major depressive group. These findings suggest that mixed affective states do not exist as a separate entity, but are compared of two subgroups obtained from the manic and major depressive categories.