DEPRESSION IN THE STRUCTURE OF SOMATOFORM DISORDERS IN CHILDREN, ITS SIGNIFICANCE, THE ROLE OF SEROTONIN AND TRYPTOPHANE IN THE EMERGENCE OF THESE DISORDERS
Pypa L., Lysytsia Yu., Svistilnik R., Rimsha S., Kernychnyi V.
National Pyrogov Memorial Medical University, Vinnytsia, Ukraine
The aim of the study - is to investigate the presence of depres- sive disorders and their manifestation in children with somato- form disorders (SD) from di erent organs and systems and to establish the role of disorders of serotonin and tryptophan me- tabolism in their occurrence.
111 children were diagnosed with SD. The average age of chil- dren was 13,6±2,3 years, among them boys were 42 (37,8%) and girls – 69 (62,2%). The patients were divided into two groups: children with SD without depression 63 (56,8%) and children with SD with depression 48 (43,2%). For diagnosing of depression it was used a questionnaire for childhood depression of M. Kovacs. The determination of blood serum concentration of serotonin was car- ried out by biochemical method, tryptophan – by chromatographic.
The depression was diagnosed in 48 (43,2%) children of which it was mild - in 14 (29,2%), moderate - in 27 (56,2%) and severe depression - in 7 (14,6%) children. Depression was more common in girls - 34 (70,8%), in relation to boys 2,4:1. The serotonin level in children with depression was 1,03 ± 0,37 μmol/L, and it was lower to compare with children without depression (1,30 ± 0,27 μmol/L) (95% CI, 0,15 – 0,39 μmol/L, p<0,0001). The level of tryptophan in children with depression was 0,035 ± 0,031 mmol/L and it was higher to compare with children without depression (0,026 ± 0,026 mmol/L) (p>0,05). Low levels of serotonin were associated with a negative mood (95% CI, 0,02 - 0,30 μmol/L, p<0,02), anhedonia (95% CI, 0,11 - 0,36 μmol/L, p<0,0003). It was found the moderate and inverse correlation between serotonin and tryptophan in SD in children with depres- sion (r = -0,342; 95% CI for r, -0,65 to -0,034, p<0,05).
A low serotonin level was associated with depression and it was not associated with SD without depression. With a de- crease in serotonin concentration the level of tryptophan in- creases which can indicate about the violation of the chain of tryptophan-serotonin and its involvement in the development of depression in SD.