Red-cell lithium transport and affective disorders in a multigeneration pedigree: evidence for genetic transmission of affective disorders

The genetics of bipolar disorder

Growing interest in the application of molecular biological techniques to psychiatric disorders has reinvigorated interest in the genetics of the psychoses. It is therefore timely to review the current state of knowledge of the genetics of bipolar disorder. Family, twin and adoption studies are all consistent in confirming the strongly heritable nature of this condition. As segregation analyses have been unable to determine the mode of transmission of bipolar disorder, ongoing linkage analyses using DNA markers will be crucial in determining whether this condition is due to a single major gene, a small number of genes, or multifactorial polygenic inheritance.

Erythrocyte membrane structure in bipolar affective disorder: a non-replication

Fifteen bipolar patients were compared with sixteen controls in an attempt to replicate the findings of Pettegrew et al. in 1982 of decreased fluidity in the hydrocarbon core of the erythrocyte membrane. No significant differences were seen between groups. The present control group shows very similar membrane characteristics to the original control series; however, the bipolar patient group is not similar. Possible explanations are discussed.

Lithium distribution in mania: single-dose pharmacokinetics and sympathoadrenal function

We examined lithium distribution after a single dose of 25 mEq in 14 drug-free manic patients. Lithium concentrations were measured in plasma, red blood cells, and urine. Maximum concentrations of lithium, times at which they were attained, and influx and efflux rate constants for extracellular fluid, red blood cell, and muscle-like compartments were estimated using a three-compartment pharmacokinetic model. Tissue lithium concentrations may continue to increase for hours after plasma lithium concentrations have peaked. Rate constants for absorption, excretion, and influx and efflux for the tissue compartments were similar to those previously reported for normal subjects. Rate constants for transport into and out of the tissue compartments correlated negatively with norepinephrine or epinephrine excretion and positively with the plasma/red cell Na+ gradient. Rate constants for efflux from red blood cell and muscle compartments correlated with measures of adrenocortical function and were higher in dexamethasone nonsuppressors than in suppressors. These data show that distribution of lithium may be related to sympathodrenal activity and Na+ distribution in manic patients.

Lithium ratio in vitro: familial patterns of illness

Psychiatric illness in first-degree relatives of psychotic patients with low, intermediate, and high red blood cell (RBC) in vitro lithium ratio (LR) was investigated using the Schedule for Affective Disorders and Schizophrenia and DSM-III. Fewer schizophrenic spectrum disorders were found in the first-degree relatives of high and low LR probands as compared to intermediate LR probands; high LR psychotic probands had families with an increased frequency of depressive spectrum disorder. Alcohol dependence and abuse was particularly prominent in the first-degree relatives of the higher LR probands. High LR may identify a disease that does not belong to the familial-genetic disorders of the schizophrenic spectrum; this illness may bear a closer relationship to disorders of the depressive spectrum.