Vascular correlates of circular type manic-depressive disorder

An ambulant patient with a regular series of mood changes constantly varying between retarded depression and hypomania on a 32- to 36-day cycle was studied for 39 weeks. The patient completed a daily self-assessment of the 11-point Dorland mood scale each evening. This scale encompasses a range of moods varying from depression through euthymia to mania. Weekly recordings each lasting 65 min were made of resting heart rate, 14 parameters derived from electrical impedance plethysmography of the head together with arterial blood pressures before and after each recording. Results were correlated with the changing mood scores. Time series analysis of the mood scores yielded a recurrent mood cycle of 35 days unchanged by such drug treatments as had been prescribed by the psychiatrist. The mood score correlated positively with the impedance amplitude, inflow angle, and transit times, and negatively with percent rise time, heart rate, and blood pressures. Amplitudes, rise times, and CT2 were independent of heart rate and blood pressures and hence probably related more closely to cerebral blood flow.