Objective: Anxiety and depressive disorders are known to be associated with metabolic and electrolyte disorders in patients with critical illness. Oxidative stress is one of the important mechanisms that causes the destruction of nerve cells and decrease the volume of hippocampus in patients of major depression. The major antioxidative defences include both enzymatic and nonenzymatic antioxidants. Albumin, bilirubin, uric acid and ascorbic acid are some of the nonenzymatic antioxidants in the body. The nonenzymatic antioxidant levels are also modified in major depression. Accumulating evidence suggest lowering of these antioxidants in patients of major depression. However this relationship is not fully understood in elective (outpatient) patients. In this study we try to determine the relationship between anxiety and depressive disorders with uric acid levels in outpatients.
Method: In this cross-sectional study, we enrolled 100 patients with suspected symptoms of anxiety and/or depressive disorders, which come to psychiatry outpatient clinic. Assessment of the anxiety and/or depressive disorders was made by using BECK scales. In addition, demographic data (age, gender and BMI), hematological indexes, renal function tests, liver function tests, thyroid function tests, vit B12, lipid panel, GGT and Uric Acid levels were measured from these patients.
Results: The mean age of the patients who were enrolled in the study was 41.9±10.9 and 81% of them were female. According to BECK scale anxiety were present in 80% of the patients and depression present in 69% of the patients. Serum hemoglobin, creatinine, ALT, FT3, B12, lymphocyte ratio and serum uric acid levels were significantly lower in patients with depression. In multivariate analysis serum levels of uric acid and BECK depression scores were correlated with each other with statistically borderline significance (p=0.086). Serum calcium, potassium and serum uric acid levels were significantly lower in the patients with anxiety. In multivariate analysis only serum uric acid levels were correlated with BECK anxiety scores with statistically significance (p=0.086), the other variables were not. There had been a negative correlation between serum uric acid levels and BECK anxiety scores (r= -0.389, p<0.001) and sensitivity of the serum uric acid level > 4.55 cut-off value was 37% and specificity was 18% (AUC: 0.666, 96%CI 0.532 – 0.801, p=0.038).
Conclusion: In this study we determine a significant correlation between serum uric acid levels and anxiety disorder. Elevation in serum uric acid level seems to be protective against anxiety disorder. Pathophysiological and clinical effects of this will be eligible to appear with broader studies.