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.