THYROID-FUNCTION ASSESSMENT IN PSYCHIATRI C-PATIENTS

Background: Thyroid dysfunction is frequent in psychiatric outpatients and the correction of their endocrine abnormalities seems to improve the response to psychopharmacologic treatment. Aim: To retrospectively explore the frequency of thyroid abnormalities in psychiatric outpati ents. Material and methods: Clinical charts and thyroid assessment of 102 psychiatric patients aged 40.8 +/- 15 years old (28 male) seen bet ween April 1995 and September 1996 were reviewed. Endocrine diagnosis was made according to international criteria and psychiatric diagnosis was made by a single psychiatrist following DSM IV criteria. Results: Forty patients (39.2%) had thyroid abnormalities. Thirteen (12.7%) ha d a diagnosis of thyroid problems and were in treatment before they ca me to the psychiatric clinic. Sixteen patients had hypothyroidism (40% ), seven had subclinical hypothyroidism (17.5%), 12 were euthyroid but had goiter or positive thyroid antibodies (30%) and 5 individuals had hyperthyroidism (12.5%). The most frequent thyroid abnormality was th e presence of positive thyroid antibodies in 16 cases (15.7%). No spec ific association was found between psychiatric and endocrine diagnoses . Conclusions: The design of this study prevents to draw conclusions a bout prevalence of thyroid alterations in psychiatric patients. Nevert heless results support the need for routine thyroid assessment in this specific population.