Level of Thyroid-Stimulating Hormone (TSH) in Patients with Acute Schizophrenia, Unipolar Depression or Bipolar Disorder

Abstract

The aim of this study is to investigate differences in thyroid-stimulating hormone (TSH) level in patients with acute schizophrenia, unipolar depression, bipolar depression and bipolar mania. Serum level of TSH was measured in 1,685 Caucasian patients (1,064 women, 63.1 %; mean age 46.4). Mean serum TSH concentration was: schizophrenia (n = 769) 1.71 μIU/mL, unipolar depression (n = 651) 1.63 μIU/mL, bipolar disorder (n = 264) 1.86 μIU/mL, bipolar depression (n = 203) 2.00 μIU/mL, bipolar mania (n = 61) 1.38 μIU/mL (H = 11.58, p = 0.009). Depending on the normal range used, the overall rate of being above or below the normal range was 7.9–22.3 % for schizophrenia, 13.9–26.0 % for unipolar depression, 10.8–27.6 % for bipolar disorder, 12.2–28.5 % for bipolar depression, and 11.4–24.5 % for bipolar mania. We have also found differences in TSH levels between the age groups (≤20, >20 years and ≤40, >40 years and ≤60 years and >60 years). TSH level was negatively correlated with age (r = − 0.23, p < 0.001). Weak correlations with age have been found in the schizophrenia (r = − 0.21, p < 0.001), unipolar depression (r = − 0.23, p < 0.001), bipolar depression (r = − 0.25, p = 0.002) and bipolar disorder (r = − 0.21, p = 0.005) groups. Our results confirm that there may be a higher prevalence of thyroid dysfunctions in patients with mood disorders (both unipolar and bipolar) and that these two diagnostic groups differ in terms of direction and frequency of thyroid dysfunctions.

Correlation between Intrinsic Brain Activity and Thyroid-Stimulating Hormone Level in Unmedicated Bipolar II Depression

“…Lower TSH ­level was found in bipolar II depression patients when compared to HCs, however, the average TSH value is still within the normal range of TSH serum level in our study. A rate of 12.2–28.5% being above or below the normal range of TSH was found in bipolar depression patients, suggesting a higher prevalence of thyroid dysfunction in BD depression (bipolar I and II) [17]. The main reason for this result may be that the sample size is too small to determine the HPT axis dysfunction in bipolar II depression patients.…”

“…The relationship between endocrine disturbances and BD has been reported in a large number of researches [16, 17]. Previous study found that hypothalamic-pituitary-thyroid (HPT) axis abnormalities play an important role in the pathophysiology and treatment of BD [18].…”

“…A recent study in BD found that using total tri-iodothyronine (TT3) as an adjunctive treatment could augment and accelerate treatment response to medicines, such as antidepressants and lithium, especially for treatment-resistant bipolar II depression [21]. And there were differences of thyroid-stimulating hormone (TSH) levels between bipolar depression and bipolar mania [17]. What’s more, TSH is correlated with depression severity [22].…”

Thyroid profile in depression: a cross-sectional study from North-East India

“…9,10,23,24 The prevalence of both overt and subclinical hyperthyroidism was lower than those observed by previous studies. 25,26 These variations in our results might be due to the fact that most of those studies were based only on serum TSH level, whereas our interpretation was more accurate, based on TSH, T3, T4 and free T4 level estimation.…”

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“…In a study done in India by Radhakrishnan et al [1] abnormal thyroid hormonal status was found in 29% of patients with schizophrenia 23.2 % in patients with mood disorders had abnormal TSH [1]. Meanwhile a study in Poland showed that the prevalence of thyroid dysfunction was higher in mood disorders [2]. Hu LY et al [3] explored the relationship of hyperthyroidism and the subsequent development of bipolar disorders and they found that patients with hyperthyroidism were more likely to develop bipolar disorder [3].…”