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Master Thesis

Le Métabolisme monocarboné : un facteur de médiation du trouble dépressif

Abstract : Background : depressive disorder is a frequent, heterogeneous disorder associated with a high risk of suicide. For several years, one-carbon metabolism has been particularly studied and seems to be a mediating factor in this heterogeneous disorder. Through this study we wish to study the links between the factors of one-carbon metabolism (vitamin B9, B12, homocysteine) and unipolar depression in terms of severity, duration of symptoms, therapeutic resistance in order to determine from a clinical point of view the thresholds of significance of these factors in the practice of psychiatry. Methods : an epidemiological, observational and retrospective study was carried out in an adult psychiatric ward in Paris. The selection criteria were any patient who had been hospitalized between 2016 and 2018, had a plasma folate, vitamin B12, homocysteine assay on admission and the inclusion criterion was to have a diagnosis of unipolar depressive episode. Reports from selected patients were extracted and analyzed by a clinician to assess Maudsley's score, clinical global impression score of severity, and the existence of confounding variables. Results : 202 patients were included. Our study did not allow us to highlight significance thresholds of one-carbon metabolism factors in terms of severity, duration and therapeutic resistance for the unipolar depressive episode despite the high prevalence of these abnormalities. There was a prevalence of 20.5% folate deficiency, 23.9% vitamin B12 deficiency and 10.8% hyperhomocysteinemia. There was a statistically significant association between folate deficiency and the Maudsley resistance score (p=0.02). Conclusion : further investigation with more powerful studies is necessary to better characterize this link between folate levels and resistance of the depressive episode. However, our study raises the question of routine dosing of these markers in psychiatric wards.
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Master Thesis
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Submitted on : Monday, December 6, 2021 - 11:25:36 AM
Last modification on : Thursday, April 7, 2022 - 2:28:02 PM
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Anne Leprince. Le Métabolisme monocarboné : un facteur de médiation du trouble dépressif. Médecine humaine et pathologie. 2020. ⟨dumas-03466837⟩



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