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July 20, 1979, Vol 242, No. 3 >
ARTICLE | July 20, 1979

Thyroid Function Screening in Psychiatric Patients FREE

Kenneth L. Cohen, MD; Mary E. Swigar, MD
[+] Author Affiliations

Reprint requests to Department of Medicine, Yale-New Haven Hospital, 2074 LMP, New Haven, CT 06510 (Dr Cohen).


JAMA. 1979;242(3):254-257. doi:10.1001/jama.1979.03300030026015
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References

Abnormalities in levels of total thyroxine and thyroxine binding capacity were common in a group of 480 newly admitted psychiatric patients. The estimated free thyroxine (EFT4) level was elevated in 43 patients (9%). In 27 of these patients, the level of EFT4 became spontaneously normal, usually within a two-week period (acute "stress hyperthyroidism"). The level of EFT4 was decreased in 42 patients (9%). In 16 of these patients, the level became spontaneously normal; the etiology of this apparent acute hypothyroidism is unclear. The yield of new cases of primary hyperthyroidism and hypothyroidism was low, but a presumptive diagnosis of secondary hypothyroidism was made in eight patients. In addition, nine patients with known thyroid disease were taking inadequate or excessive replacement therapy. Thyroid function screening tests are of value in psychiatric patients.

(JAMA 242:254-257, 1979)

REFERENCES

1 +
Whybrow PC, Prange AJ Jr, Treadway CR:  Mental changes accompanying thyroid gland dysfunction . Arch Gen Psychiatry 20:48-63, 1969;.
2 +
Nicholson G, Liebling LI, Hall RA:  Thyroid dysfunction in female psychiatric patients . Br J Psychiatry 129:236-238, 1976;.
3 +
Weinberg AD, Katzell TD:  Thyroid and adrenal function among psychiatric patients. Lancet 1:1104-1105, 1977;.
4 +
Bursten B:  Psychoses associated with thyrotoxicosis . Arch Gen Psychiatry 4:267-273, 1961;.
5 +
Clower CG, Young AJ, Kepas D:  Psychotic states resulting from disorders of thyroid function . Johns Hopkins Med J 124:305-310, 1969;.
6 +
Chopra IJ, Chopra U, Smith SR, et al:  Reciprocal changes in serum concentrations of 3,3′,5′-triiodothyronine (reverse T,) and 3,3′,5-triiodothyronine (T,) in systemic illness . J Clin Endocrinol Metab 41:1043-1049, 1975;.
7 +
Seligson H, Seligson D:  Measurement of thyroxine by competitive protein binding . Clin Chim Acta 38:199-205, 1972;.
8 +
Seligson H, Seligson D:  Measurement of serum thyroxine binding capacity . Clin Chim Acta 89:47-58, 1978;.
9 +
Lee ND, Henry RJ, Golub OJ:  Determination of the free thyroxine content of serum . J Clin Endocrinol Metab 24:486-495, 1964;.
10 +
Meerkin M, Thompson MM, Stewart M:  Thyroid profiling in a hospital population , abstracted. Clin Chem 21:951, 1975;.
11 +
Tunbridge WMG, Evered DC, Hall R, et al:  The spectrum of thyroid disease in a community: The Whickham survey . Clin Endocrinol 7:481-493, 1977;.
12 +
Bermudez F, Surks MI, Oppenheimer JH:  High incidence of decreased serum triiodothyronine concentration in patients with nonthyroidal disease . J Clin Endocrinol Metab 41:27-40, 1975;.
13 +
Lutz JH, Gregerman RI, Spaulding SW, et al:  Thyroxine binding proteins, free thyroxine and thyroxine turnover interrelationships during acute infectious illness in man . J Clin Endocrinol Metab 35:230-249, 1972;.
14 +
Ramirez G, O'Neill W, Jubiz W, et al:  Thyroid dysfunction in uremia: Evidence for thyroid and hypophyseal abnormalities . Ann Intern Med 84:672-676, 1976;.
15 +
Carter JN, Eastman CJ, Cocoran JM, et al:  Effect of severe, chronic illness on thyroid function . Lancet 2:971-974, 1974;.
16 +
Kapstein E, Kamiel M, Spencer C, et al:  Suppression of thyroid function with severe illness , abstracted. Clin Res 26:147, 1978;.
17 +
Hansen JM, Skovsted L, Lauridsen UB, et al:  The effect of diphenylhydantoin on thyroid function . J Clin Endocrinol Metab 39:785-789, 1974;.
18 +
Kolakowska T, Swigar ME:  Thyroid function in depression and alcohol abuse . Arch Gen Psychiatry 34:984-988, 1977;.
19 +
Lloyd GG, Rosser RM, Crowe MJ:  Effect of lithium on thyroid in man . Lancet 2:619, 1973;.
20 +
Croxson MS, Ibbertson HK:  Low serum triiodothyronine (T,) and hypothyroidism in anorexia nervosa . J Clin Endocrinol Metab 44:167-174, 1977;.

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1 +
Whybrow PC, Prange AJ Jr, Treadway CR:  Mental changes accompanying thyroid gland dysfunction . Arch Gen Psychiatry 20:48-63, 1969;.
2 +
Nicholson G, Liebling LI, Hall RA:  Thyroid dysfunction in female psychiatric patients . Br J Psychiatry 129:236-238, 1976;.
3 +
Weinberg AD, Katzell TD:  Thyroid and adrenal function among psychiatric patients. Lancet 1:1104-1105, 1977;.
4 +
Bursten B:  Psychoses associated with thyrotoxicosis . Arch Gen Psychiatry 4:267-273, 1961;.
5 +
Clower CG, Young AJ, Kepas D:  Psychotic states resulting from disorders of thyroid function . Johns Hopkins Med J 124:305-310, 1969;.
6 +
Chopra IJ, Chopra U, Smith SR, et al:  Reciprocal changes in serum concentrations of 3,3′,5′-triiodothyronine (reverse T,) and 3,3′,5-triiodothyronine (T,) in systemic illness . J Clin Endocrinol Metab 41:1043-1049, 1975;.
7 +
Seligson H, Seligson D:  Measurement of thyroxine by competitive protein binding . Clin Chim Acta 38:199-205, 1972;.
8 +
Seligson H, Seligson D:  Measurement of serum thyroxine binding capacity . Clin Chim Acta 89:47-58, 1978;.
9 +
Lee ND, Henry RJ, Golub OJ:  Determination of the free thyroxine content of serum . J Clin Endocrinol Metab 24:486-495, 1964;.
10 +
Meerkin M, Thompson MM, Stewart M:  Thyroid profiling in a hospital population , abstracted. Clin Chem 21:951, 1975;.
11 +
Tunbridge WMG, Evered DC, Hall R, et al:  The spectrum of thyroid disease in a community: The Whickham survey . Clin Endocrinol 7:481-493, 1977;.
12 +
Bermudez F, Surks MI, Oppenheimer JH:  High incidence of decreased serum triiodothyronine concentration in patients with nonthyroidal disease . J Clin Endocrinol Metab 41:27-40, 1975;.
13 +
Lutz JH, Gregerman RI, Spaulding SW, et al:  Thyroxine binding proteins, free thyroxine and thyroxine turnover interrelationships during acute infectious illness in man . J Clin Endocrinol Metab 35:230-249, 1972;.
14 +
Ramirez G, O'Neill W, Jubiz W, et al:  Thyroid dysfunction in uremia: Evidence for thyroid and hypophyseal abnormalities . Ann Intern Med 84:672-676, 1976;.
15 +
Carter JN, Eastman CJ, Cocoran JM, et al:  Effect of severe, chronic illness on thyroid function . Lancet 2:971-974, 1974;.
16 +
Kapstein E, Kamiel M, Spencer C, et al:  Suppression of thyroid function with severe illness , abstracted. Clin Res 26:147, 1978;.
17 +
Hansen JM, Skovsted L, Lauridsen UB, et al:  The effect of diphenylhydantoin on thyroid function . J Clin Endocrinol Metab 39:785-789, 1974;.
18 +
Kolakowska T, Swigar ME:  Thyroid function in depression and alcohol abuse . Arch Gen Psychiatry 34:984-988, 1977;.
19 +
Lloyd GG, Rosser RM, Crowe MJ:  Effect of lithium on thyroid in man . Lancet 2:619, 1973;.
20 +
Croxson MS, Ibbertson HK:  Low serum triiodothyronine (T,) and hypothyroidism in anorexia nervosa . J Clin Endocrinol Metab 44:167-174, 1977;.

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