THE DIAGNOSIS AND TREATMENT OF SUBCLINICAL HYPOTHYROID STATES IN DEPRESSED-PATIENTS

The diagnosis and treatment of subclinical hypothyroidism in mood-diso rdered patients is complex and somewhat controversial. The psychiatris t must recognize that such sub-clinical states may contribute to depre ssion, mood cycling, or delayed response to treatment if undetected. A utoimmune thyroiditis, which may ultimately lead to various grades of hypothyroidism, may also be seen in depressed populations, particularl y in postpartum females. The author discusses these issues by means of a clinical vignette, then proposes an algorithm for the diagnosis and treatment of hypothyroid states in mood disordered populations. (C) 1 997 Elsevier Science Inc.