Exploring the Role of Serum Hydrogen Sulphide (H2S) Levels in Manic Depressive Psychosis in Terms of Its Association, Diagnostic Ability, and Severity Prediction: Findings From a Tertiary Care Center in North Bengal

Sutapa S Dutta; Sayantan Dasgupta; Arup K Banerjee; Indrajit Nath; Utpal Biswas; Nirmal Bera; Alice Ruram

doi:10.7759/cureus.56857

Exploring the Role of Serum Hydrogen Sulphide (H2S) Levels in Manic Depressive Psychosis in Terms of Its Association, Diagnostic Ability, and Severity Prediction: Findings From a Tertiary Care Center in North Bengal

Cureus. 2024 Mar 24;16(3):e56857. doi: 10.7759/cureus.56857. eCollection 2024 Mar.

Authors

Sutapa S Dutta¹, Sayantan Dasgupta², Arup K Banerjee³, Indrajit Nath⁴, Utpal Biswas², Nirmal Bera⁵, Alice Ruram⁴

Affiliations

¹ Biochemistry, West Bengal Health Service, Kolkata, IND.
² Biochemistry, North Bengal Medical College and Hospital, Siliguri, IND.
³ Biochemistry, Prafulla Chandra Sen Government Medical College and Hospital, Arambag, IND.
⁴ Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.
⁵ Psychiatry, North Bengal Medical College and Hospital, Siliguri, IND.

Abstract

Introduction: Manic depressive psychosis (MDP) or bipolar disorder, a prevalent psychiatric condition globally and in the Indian population, has been attributed to various pathological mechanisms. Hydrogen sulphide (H₂S), a member of the gasotransmitter family, may be linked to the development of bipolar disorder because it plays a crucial role in maintaining proper neuronal function in terms of excitability, plasticity, and homeostatic functions. There is very little data regarding the role of the gasotransmitter H₂S in MDP in terms of its association, diagnostic ability, and severity prediction, which led us to conduct this study among MDP patients in the Sub-Himalayan region of West Bengal.

Methods: This was an observational case-control study performed in the Department of Biochemistry, North Bengal Medical College and Hospital, Siliguri, West Bengal, India, from January 2022 to December 2022. Fifty diagnosed MDP patients and 50 healthy age- and sex-matched control subjects satisfying the inclusion and exclusion criteria were studied. The H₂S level in the blood was assayed using the standardised spectrophotometric methylene blue method. The severity of depression was assessed by Hamilton Depression Rating Scale (HAM-D) scoring.

Results: Of the 50 MDP patients, 45 (90%) were in the depressive phase, and five (10%) were in the manic phase. Of the 45 depressive patients, eight (17.8%) had mild depression, 12 (26.7%) had moderate depression, 19 (42.2%) had severe depression, and six (13.3%) had very severe depression. The mean H₂S level in MDP patients (41.98±18.88 μmol/l) was significantly (P<0.05) lower than that in control subjects (99.20± 15.20 μmol/l). It was also observed that the mean H₂S level in MDP patients decreased with the duration of the disease but was not statistically significant. The mean H2S levels in the different depression severity groups were found to be significantly different (P<0.001). Receiver operating characteristic (ROC) curve analysis revealed that a cut-off value of H₂S <78.5 μmol/l was associated with MDP, with a sensitivity of 96% and a specificity of 88%, and a cut-off value of H₂S < 53 μmol/l predicted the severity of depression with a sensitivity of 89.3% and a specificity of 76.5%.

Conclusion: The significant association of the gasotransmitter H₂S in MDP patients and its role as a diagnostic and severity predictive marker can help us to employ proper measures for better management of MDP and improving quality of life.

Keywords: bipolar disorder (bpd); gasotransmitter; hamilton depression rating scale (ham-d); hydrogen sulphide (h2s); manic depressive psychosis (mdp); receiver operating characteristics (roc).