High prevalence of thyroid abnormalities in a Chilean psychiatric outpatient population

Abstract

The aim of the present study was to establish the prevalence of thyroid disturbances in patients consulting for panic and mood disorders. These data may be relevant because thyroid functional alterations affect the success of treatment in these pathologies. We studied prospectively 268 psychiatric outpatients (204 females and 64 males) diagnosed by DSM-IV criteria. We excluded patients with addictive disorders and major medical disease. We measured TSH, Free T4 (FT4) and antimicrosomal antibodies (AMA). We diagnosed classical hypothyroidism when the TSH value was >10 microUI/ml (NV=0.25-4.3) and subclinical hypothyroidism when the TSH value was between 5-10 microUI/ml. Hyperthyroidism was diagnosed when FT4 >1.4 (NV=0.8-1.4), the TSH suppressed and the radioiodine uptake >20% (NV=5-15). Positive antimicrosomal antibodies (AMA) titres were >1:100 dilution. Hypothyroidism was diagnosed in 26/268 patients (9.7%); 10 cases corresponded to the classical form (38.5%) and 16 cases to the subclinical form (61.5%). Hyperthyroidism was found in 6/268 patients (2.2%). Normal thyroid function with positive AMA was found in 28/268 patients (10.4%). Hypothyroidism was more common in patients with mood disorders, and hyperthyroidism in patients with panic disorders. Patients with panic disorder had significant higher levels of FT4. The prevalence of positive AMA, hypothyroidism and hyperthyroidism was higher in women than men. We found a high frequency of thyroid abnormalities in a psychiatric outpatient population. These data suggests that routine evaluation of thyroid function should be considered in patients consulting for mood and panic disorders.

Lack of confirmation of thyroid endophenotype in Bipolar Disorder Type I and their first-degree relatives

“…TG-Abs and TPO-Abs positivization in our samples were very similar to some thyroid ''naïve'' samples in Catalonia (Serna et al, 2000), but superior to other samples of healthy non-iodine deficient subjects from the same region (Lucas et al, 2010), and different from other previous studies with BD-I samples (Joffe et al, 1988;Haggerty et al, 1990;Fardella et al, 2000;Vonk et al, 2007).…”

“…The number of positive thyroidal anti-bodies in BD reported in the literature varies between 13% (Haggerty et al, 1990) and19% (Joffe et al, 1988) or even up to 28-29% (Fardella et al, 2000;Vonk et al, 2007), especially in the case of patients with rapid cycles (Oomen et al, 1996). In the general population, the presence of thyroid antibodies also appears to be influenced by gender, age (Szabolcs et al, 1995), pregnancy (Nohr et al, 2000) or nutritional state -mainly by the relative presence of iodine in the diet - (Hansen et al, 2006).…”

“…An increased rate of thyroid antibodies has been detected for many years in various psychiatric diseases, mainly in major depression (Laske et al, 2008), postpartum depression (Pop et al, 2006), bipolar disorder (Joffe et al, 1988;Haggerty et al, 1990;Oomen et al, 1996;Kupka et al, 2002;Chakrabarti, 2011) and other affective disorders (Haggerty et al, 1997;Fardella et al, 2000). Other severe psychiatric disorders, such as schizophrenia, do not show the same association (Laske et al, 2008), although other large study revealed a significant association between schizophrenia and various autoimmune diseases (Eaton et al, 2006).…”

The Effectiveness of Thyroid Function Tests Screening in Psychiatric Inpatients

“…While some clinics screen all psychiatric patients, others only screen specific patient groups. Some study results suggest that routine evaluation of thyroid function should be considered in patients presenting with mood and panic disorders (27), while the results of other surveys do not support this suggestion. In order to eliminate unnecessary TFT, some researchers…”

Refractory depression in a patient with peripheral resistance to thyroid hormone (RTH) and the effect of triiodothyronine treatment

“…Up to date it is known that hypo-and hyper-thyroid patients may share similar symptoms with those observed in psychiatric pathologies [1][2][3].…”