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Disturbances of Glucose Tolerance and of the Acid-Base Equilibrium in Manic-Depressive Insanity

Published online by Cambridge University Press:  08 February 2018

J. K. Marshall*
Affiliation:
Long Grove Hospital

Extract

It has been recognized for many years that in certain cases of mental disorder there is a demonstrable disturbance of carbohydrate metabolism. Among early observations may be mentioned those of Raimann (1902), Schultz and Knauer (1909) and Laudenheimer (1898). These workers reported the presence of sugar in the urine of patients suffering from depressive and anxiety states, and noted that the glycosuria often varied with the severity of the mental disturbances and disappeared with them. They remarked, however, that the phenomenon was of little diagnostic importance, inasmuch as it could be found in depressive states associated with many different types of mental illness. Such observations were of value as an indication for further research, but until it was established that the glycosuria was not due to a derangement of the renal mechanism of sugar excretion, it could not be claimed that the findings indicated such a fundamental metabolic disturbance as is now known to exist. Although Santenoise and Tinel (1923) stated that the renal threshold varies according to the mental state of the patient, many more recent workers have shown that the increased sugar excretion is always associated with a greater or less degree of hyperglycæmia, and, although agreement on this point is not complete, the balance of evidence favours the belief that such hyperglycæmia is alimentary in origin, and not spontaneous. As the earliest workers appeared to recognize, the metabolic disturbance is found mainly in states of depression, which may be retarded or agitated, and in certain cases of schizophrenia, which, too, may be stuporose or restless. Some investigators are of the opinion that the same disturbance may be found in states of mania as well as or even to the exclusion of depressive states, but this is a view which is held only by a minority.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1939 

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References

References.

Abderhalden, E., and Wertheimer, E.—“Studien über den Einfluss der Ernährung auf die Wirkung bestimmter Inkretstoffe”: quoted by Mann, and Scott, (1929), Pflüg. Arch. ges. Physiol., 1924, ccv, p. 547.Google Scholar
Armstrong, K. W.—“An Investigation into the Distribution of Chlorine in the Blood and Urine in Certain Types of Mental Disorder,” Journ. Ment. Sci., 1929, lxxv, p. 644.CrossRefGoogle Scholar
Baillif, L., and Gherscovici, I.—“L'équilibre acido-basique dans les maladies nerveuses et mentales,” C.R. Soc. Biol., Paris, 1931, cviii, p. 995.Google Scholar
Barrett, T. M., and Serre, P.—“Blood Analysis and Sugar Tolerance Tests in Mental Disease,” Journ. Nerv. and Ment. Dis., 1924, lix, p. 561.CrossRefGoogle Scholar
Bertram, F.—“Die Bedeutung der Acidose und Alkalose für den Kohlenhydratstoffwechsel,” Zeitschr. ges. exp. Med., 1924, xliii, p. 421.CrossRefGoogle Scholar
Bogen, D.—“Biological Studies of the Blood in the Affective Psychoses,” Rev. Psychiat. Neurol. Reflexol. (Leningrad), 1929, iv, p. 78. Abstr. Amer. Journ. Psychiat., 1930, ix, p. 1161.Google Scholar
Bowman, K. M.—“Blood Chemistry in Mental Diseases,” Amer. Journ. Psychiat., 1922, ii, p. 379.Google Scholar
Idem and Kasanin, J.—“The Sugar Content of the Blood in Emotional States,” Arch. Neurol. Psychiat., Chicago, 1929, xxi, p. 342.Google Scholar
Calvert, E. G. B.—“Estimation of Sugar in the Blood,” Biochem. Journ., 1924, xviii, p. 839.CrossRefGoogle Scholar
Cannon, W. B., and de la Paz, D.—“Emotional Stimulation of Adrenal Secretion,” Amer. Journ. Physiol., 1911, xxviii, p. 264.Google Scholar
Cannon, W. B., Shohl, A. T., and Wright, W. S.—“Emotional Glycosuria,” ibid., 1911, xxix, p. 280.Google Scholar
Cordier, D.—“Action de l'acide carbonique sur la glycémie,” Ann. Physiol. Physicochem. biol., 1934, x, p. 1.Google Scholar
Davenport, H. A.—“Liver Amylase and its Probable Role in the Regulation of Blood Sugar,” Journ. Biol. Chem., 1926, lxx, p. 625.CrossRefGoogle Scholar
Diethelm, O.—“Influence of Emotions on Dextrose Tolerance,” Arch. Neurol. Psychiat., Chicago, 1936, xxxvi, p. 342.CrossRefGoogle Scholar
Drury, K. K., and Farran-Ridge, C.—“Some Observations on the Types of Blood-sugar Curve Found in Different Forms of Insanity,” ∗∗∗Joum. Ment. Sci., 1925, lxxi, p. 8.CrossRefGoogle Scholar
Edie, E. S., Moore, B., and Roaf, H. E.—“Studies on Glycosuria,” Biochem. Journ., 1911, v, p. 325.CrossRefGoogle Scholar
Edwards, K. T., Richards, T. K., and Dill, D. B.—“Blood Sugar, Urine Sugar and Urine Protein in Exercise,” Amer. Journ. Physiol., 1931, xcviii, p. 352.CrossRefGoogle Scholar
Elias, H.—“Über die Rolle der Säure im Kohlehydratstoffwechsel,” Biochem. Z., 1913, xlviii, p. 120.Google Scholar
Freeman, W.—“The Fasting Blood Sugar in Schizophrenia,” Amer. Journ. Med. Sci., 1933, clxxxvi, p. 621.CrossRefGoogle Scholar
Gamble, F. M.—“Some Laboratory Findings in the Routine Investigation of Acute Admissions,” Journ. Ment. Sci., 1930, lxxvi, p. 292.CrossRefGoogle Scholar
Gesell, R.—“The Chemical Regulation of Respiration,” Physiol. Rev., 1925, v, p. 551.CrossRefGoogle Scholar
Gildea, E. F., Mailhouse, V. L., and Morris, D. P.—“The Relationship Between Various Emotional Disturbances and the Sugar Content of the Blood,” Amer. Journ. Psychiat., 1935, xcii, p. 115.CrossRefGoogle Scholar
Golla, F. L.—“Some Recent Work on the Pathology of Schizophrenia,” Proc. Roy. Soc. Med., 1929, xxii, Sect. Psychiat., p. 31.Google Scholar
Idem , Mann, S. A., and Marsh, R. G. B.—“The Respiratory Regulation in Psychotic Subjects,” Journ. Ment. Sci., 1928, lxxiv, p. 443.Google Scholar
Hackfield, A. W.—“Are Physiologic Disturbances Related to the Acute Psychotic Process in the Mentally ∗∗∗Ill ?,” Arch. Neurol. Psychiat., Chicago, 1932, xxviii, p. 883.CrossRefGoogle Scholar
Haldane, J. B. S.—“Experimental and Therapeutic Alterations of Human Tissue Alkalinity,” Lancet, 1924, i, p. 537.CrossRefGoogle Scholar
Heidema, S. T.—“Blutzuckerbestimmungen bei psychiatrischen und neurologischen Patienten,” Zeitschr. f. d. ges. Neur. u. Psychiat., 1919, xlviii, p. 111.CrossRefGoogle Scholar
Henderson, Y., and Underhill, F. P.—“Acapnia and Glycosuria,” Amer. Journ. Physiol., 1911, xxviii, p. 275.CrossRefGoogle Scholar
Henry, G. W., and Mangam, E.—“Long-Section Blood Sugar Tolerance Study in Case of Depression,” Arch. Neurol. Psychiat., Chicago, 1925, xix, p. 120.Google Scholar
Jankowska, H.—“Störungen des Säurebasengleichgewichts bei manisch-depressivem Irresein und unter Affekteinflüssen,” Zeitschr. f. d. ges. Neur. u. Psychiat., 1932, cxli, p. 394.CrossRefGoogle Scholar
Abstr. Zentralbl. ges. Neurol. u. Psychiat., 1933, lxvi, p. 189.Google Scholar
Katzenelbogen, S., and Friedmann-Buchmann, E.—“Studies of Blood-sugar Curves in Mental Disorders,” Amer. Journ. Psychiat., 1933, xiii, p. 321.CrossRefGoogle Scholar
Idem and Muncie, W. S.—“Studies of Blood-sugar Curves in Mental Disorders,” Journ. Nerv. and Ment. Dis., 1935, lxxxii, p. 162.Google Scholar
Kooy, F. H.—“Hyperglycæmia in Mental Disorders,” Brain, 1919, xlii, p. 214.CrossRefGoogle Scholar
Labbe, M.Le traitement du diabète, Paris, 1926. Quoted by Katzenelbogen and Friedmann-Buchmann, 1933.Google Scholar
Labin, B.—“Recherches sur la glycémie chez les aliénés et dans quelques maladies nerveuses,” C.R. Soc. Biol. Paris, 1927, xcvi, p. 1172.Google Scholar
Langfeldt, E.—“Blood-sugar Regulation and the Origin of the Hyperglycæmias,” Journ. Biol. Chem., 1921, xlvi, p. 381.CrossRefGoogle Scholar
Laudenheimer, .—“Diabetes und Geistesstorüng,” Berl. klin. Wochenschr., 1898, No. 21–24. Quoted by Kooy, 1919.Google Scholar
Lockwood, M. R.—“A Parallel Study of the Psychogalvanic Reflex and the Hyperglycæmic Index in Psychotics,” Journ. Ment. Sci., 1932, lxxviii, p. 288.CrossRefGoogle Scholar
Looney, J. M.—“A Biochemical Study of the Blood in Mental Disorders,” Amer. Journ. Psychiat., 1924, iv, p. 29.CrossRefGoogle Scholar
Lorenz, W. F.—“Sugar Tolerance in Dementia Præcox and Other Mental Disorders,” Arch. Neurol. Psychiat., Chicago, 1922, viii, p. 184.CrossRefGoogle Scholar
MacCleod, J. J. R.—“Studies in Experimental Glycosuria,” Amer. Journ. Physiol., 1908, xxiii, p. 278.Google Scholar
Idem and Pearce, R. G.—“Studies in Experimental Glycosuria,” ibid., 1911, xxix, p. 419.Google Scholar
McCowan, P. K., and Quastel, J. H.—“Blood-sugar Studies in Abnormal Mental States,” Journ. Ment. Sci., 1931, lxxvii, p. 525.CrossRefGoogle Scholar
Mann, S. A.—“Blood-sugar Studies in Mental Disorder,” ibid., 1925a, lxxi, p. 443.Google Scholar
Idem. —“The Investigation of a Series of Cases of Early Mental Disorder by the Lævulose Test for Liver Glycogenic Efficiency,” ibid., 19256, lxxi, p. 474.Google Scholar
Idem and Marsh, R. G. B.—“The Significance of Urinary Reaction in Psychotic Subjects,” ibid., 1928, lxxiv, p. 436.Google Scholar
Idem , Morris, R. W., and Rowe, G. K.—“The Determination of Urinary Acidity,” ibid., 1928, lxxiv, p. 425.Google Scholar
Idem and Scott, F. L.—“Further Blood-sugar Studies in Mental Disorders,” Moti Memorial Volume, London, 1929, p. 279.Google Scholar
Marsh, R. G. B.—“The Excitability of the Respiratory Centre of Psychotic Patients,” Lancet, 1929, i, p. 1032.CrossRefGoogle Scholar
Menninger, W. C.—“The Inter-relationships of Mental Disorders and Diabetes Mellitus,” Journ. Ment. Sci., 1935, lxxxi, p. 332.CrossRefGoogle Scholar
Mumford, P. B., and Parkin, G. G.—“Some Observations on the Fasting Blood Sugar in Certain Mental States,” ibid., 1923, lxix, p. 330.Google Scholar
Northcote, M. L. M.—“Somatic Changes in the Psychoses,” ibid., 1932, lxxviii, p. 263.Google Scholar
Olmstead, W. H., and Gay, L. P.—“A Study of Blood-sugar Curves Following a Standardized Glucose Meal,” Arch. Intern. Med., 1922, xxix, p. 384.CrossRefGoogle Scholar
Peters, J. P., and Geyelin, H. R.—“The Relation of Adrenal Hyperglycæmia to Decreased Alkali Reserve of the Blood,” Journ. Biol. Chem., 1917, xxxi, p. 471.CrossRefGoogle Scholar
Poli, C.—“pH e riserva alcalina in malati di mente,” Riv. sper. di Freniat., 1931, lv, p. 51.Google Scholar
Abstr. Zentralbl. ges. Neurol. u. Psychiat., 1931, lx, p. 304.Google Scholar
Puca, A.—“La riserva alcalina e la tensione alveolare in alcune forme mentali,” Note Google Scholar
Psichiat., Pesaro, 1930, lix, p. 263. Abstr. Zentralbl. ges. Neurol. u. Psychiat., 1930, lviii, p. 687.Google Scholar
Raimann, .—“über Glykosurie und alimentäre Glykosurie bei Geisteskrankheiten,” Z. Heilk., 1902, xxiii. Quoted by Kooy, 1919, and others.Google Scholar
Raphael, T., Ferguson, W. G., and Searle, O. M.—“Long-Section Blood-sugar Tolerance Study in a Case of Depression,” Arch. Neurol. Psychiat., Chicago, 1928, xix, p. 120.CrossRefGoogle Scholar
Robertson, I.—“The Incidence of Digestive Alkaluria in Normal and Psychotic Subjects,” Mott Memorial Volume, London, 1929, p. 325.Google Scholar
Rous, Peyton.—“The Relative Reaction Within Living Mammalian Tissues,” Journ. Exp. Med., 1925, xli, pp. 451 and 739.CrossRefGoogle Scholar
Sacristan, J. M.—“Carbohydrate Metabolism in Endogenous Manic-depressive Psychosis,” Arch. Neurobiol. Psicol., Madr., 1934, xiv, p. 691. Abstr. ∗∗∗Journ. Ment. Sci., 1935, lxxxi, p. 716.Google Scholar
Santenoise, D., and Tinel, J.—“Glycosurie alimentaire et Système neuro-végétatif,” C.R. Soc. Biol. Paris, 1923, lxxxix, p. 148.Google Scholar
Sardo, M.—“Iperglicæmia da freddo e acidosi,” Rass. int. Clin. Terap., 1933, xiv, p. 904.Google Scholar
Schou, H. I.—“Alimentary Hyperglycæmia in Manic-depressive Psychosis,” Acta Psychiat, Kbh., 1935, x, p. 565.CrossRefGoogle Scholar
Schultz, E., and Knauer, A.—“Störungen des Kohlehydratstonwechsels bei Geisteskrankheiten,” Allg. Z. Psychiat., 1909, lxvi, p. 759.Google Scholar
Schwab, S. I.—“Diagnostic Value of Blood-sugar Curves in Neurology,” Arch. Neurol. Psychiat., Chicago, 1922, viii, p. 401.CrossRefGoogle Scholar
Scott, R. W.—“Observations on Pathologic Physiology of Chronic Pulmonary Emphysema,” Arch. intern. Med., 1920, xxvi, p. 544.CrossRefGoogle Scholar
Sleeper, F. H., and Hoskins, R. G.—“Galactose Tolerance in Dementia Præcox,” Arch. Neurol. Psychiat., Chicago, 1930, xxiv, p. 550.CrossRefGoogle Scholar
Sonden, T.A Study of Somatic Conditions in Manic-depressive Psychosis, Upsala, 1927.Google Scholar
Ström-Olsen, R.—“The Blood-sugar Curve in Mental Cases,” Lancet, 1932, i, p. 128.CrossRefGoogle Scholar
Thépénier, .—Thèse de Médecine, Paris, 1924. Quoted by Katzenelbogen and Friedmann-Buchmann, 1933.Google Scholar
Thompson, G., Mitchell, D. M., and Kolb, L. C—“The Influence of Variations in the Systemic Acid-base Balance upon the Carbohydrate Tolerance in Normal Subjects,” Biochem. Journ., 1933, xxvii, p. 1253.CrossRefGoogle Scholar
Tod, H.—“The Effect of Hypnotics on Glucose Tolerance,” ibid., 1935, xxix, p. 914.Google Scholar
Underhill, F. P.—“Studies in Carbohydrate Metabolism,” Journ. Biol. Chem., 1916, xxv, p. 463.CrossRefGoogle Scholar
Uyematsu, S., and Soda, T.—“Blood Analyses in Cases of Catatonic Dementia Præcox,” Journ. Nerv. and Ment. Dis., 1921, liii, p. 367.CrossRefGoogle Scholar
du Vigneaud, V., and Karr, W. G.—“Carbohydrate Utilization,” Journ. Biol. Chem., 1925, lxvi, p. 281.CrossRefGoogle Scholar
Visscher, M. B.—“On the Optimum pH for Glycogenase Action and its Bearing upon the Regulation of the Glucose Level in the Body,” ibid., 1926, lxix, p. 3.Google Scholar
Weston, P. G.—“Analyses of Blood of Insane Patients,” Arch. Neurol. Psychiat., Chicago, 1920, iii, p. 147.CrossRefGoogle Scholar
Whitehorn, J. C.—“The Blood Sugar in Relation to Emotional Reactions,” Amer. Journ. Psychiat., 1934, xiii, p. 988.Google Scholar
Wigert, V.—“Studien über den Zuckergehalt des Blutes bei Psychosen mit depressiven Affekten,” Zeitschr. ges. Neurol. Psychiat., 1919, xliv, p. 179.CrossRefGoogle Scholar
Wuth, .—“Der Blutzucker bei Psychosen,” Zeitschr. ges. Neurol. Psychiat., 1921, lxiv, p. 83.CrossRefGoogle Scholar
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