Role du systeme dopaminergique dans la depression: correlats cliniques du test a l'apomorphine.

Disturbances in dopaminergic neurotransmission seem to play an important role in biochemical mechanisms involved in depressive disorders. The study of the growth hormone (GH) response to apomorphine, a dopaminergic agonist, provides an indirect index of dopaminergic neurotransmission at the postsynaptic level. In the present study, we assessed the role of the dopaminergic system in some psychopathological dimensions in depression: personality dimensions, suicidal behavior, psychomotor disturbances and dichotomy unipolar/bipolar. Our studies included major depressed inpatients matched for gender, age and, in the case of women, menopausal status. Our results show that dopaminergic disturbances are related to social introversion and anxiety according to dopaminergic hypothesis of schizophrenic disorders and dopaminergic hyperactivity hypothesis of anxiety disorders. A blunted GH response to apomorphine could be considered as a biological marker of suicidal behavior. Moreover motor retardation appeared to be in relationship with dopaminergic disturbances. Finally, the dopaminergic system did not appear to play a significant role in the dichotomy unipolar/bipolar. The results show the interest of the apomorphine test in the assessment of the relationship between biochemical disturbances and clinical correlates.