In our continuing clinical CSF research, we have completed studies of monoamines and their metabolites, GABA, and 13 peptides, in 35 normal volunteers and 25 lithium-treated euthymic bipolars (15 of whom also provided samples in the unmedicated state). Strong correlations were found among seven neuropeptides studied in these subjects: CRF, VIP, N-POMC (N-Terminal fragment of pro-opiomelanocortin), ACTH, beta-endorphin, beta-lipotropin and somatostatin. CSF levels of neuropeptide Y and alpha-MSH were determined in anorexic and bulimic patients and normal volunteers. No group differences were found. Although ventricular enlargement has been reported in some affective patients, examination of computerized tomographic scans in our clinic patients has not shown evidence of increased ventricular size in comparison to controls. A family study of rapid cycling bipolar illness is in progress among the clinic patients. A review of our clinic and family study records has thus far identified 28 bipolar patients as rapid cyclers in comparison with 130 who are not. Phenylethylamine has been proposed to be an endogenous psychotomimetic agent. We have measured this substance in 24 hour urine samples and have not found a difference between patients and controls. Our longitudinal biologic and psychosocial follow-up study of offspring of bipolar parents continues. The prospective design should enable us to identify variables which are predictive of illness. Eighty-seven subjects are participating in this study at present.
