Recurrence of bipolar mania is associated with catechol-O-methyltransferase Val(108/158)Met polymorphism.

BACKGROUND

Catechol-O-methyltransferase (COMT) inactivates catecholamines, and a G-A transition in the COMT gene (rs4680) influences the enzyme activity and the interaction between cortical and subcortical dopaminergic neurotransmission. In patients affected by bipolar disorder rs4680 can influence antidepressant response and the propensity to develop psychotic symptoms, with the Met/Met genotype exerting a protective role. The same genotype could influence other dopamine-associated psychopathological features, such as mania.

METHODS

We genotyped rs4680 in a sample of 163 patients affected by bipolar disorder type I, and assessed the personal history of recurrence of the illness.

RESULTS

We observed a significant association between homozygosis for the rs4680 COMT low-activity variant and a reduced recurrence of manic, but not depressive, episodes during the course of the illness.

CONCLUSIONS

We suggest that rs4680 could be an inheritable aspect of the mechanisms of dopamine regulation that influence the individual susceptibility of patients with bipolar disorder to develop manic episodes of illness.