Abstract
The aim of this study was to determine the concentrations of thyroid axis hormones in psychotic patients on hospital admission and to search for the associations between the concentrations of these hormones and prior drug use as well as mental symptoms. MATERIAL AND METHODS. Psychiatric diagnoses, psychotropic drug use, and the severity of psychoses were evaluated using the standard methods on admission. Venous blood from patients and healthy controls was drawn for the analysis of free thyroxin (FT(4)), free triiodothyronine (FT(3)), thyroid-stimulating hormone (TSH), and sex hormone-binding globulin (SHBG) concentrations. RESULTS. Eighty-one psychotic patients, free of a thyroid disorder, were enrolled into the study. Compared with the controls, they displayed the higher FT(4) concentrations in the general group (P=0.003) and the higher SHBG concentrations only in men (P=0.013). The FT(4) concentration was higher in the patients who were not taking an antipsychotic drug on admission (P=0.039). No significant correlation was found between the severity of psychosis and concentrations of thyroid axis hormones. However, the FT(3) concentration in the general group and TSH concentration in women correlated with the factor of the Brief Psychiatric Rating Scale expressing elevated mood. CONCLUSIONS. Our study confirms the higher FT(4) concentrations in a significant proportion of acute psychotic patients. The concentrations of thyroid axis hormones were found to be associated with prior antipsychotic treatment on hospital admission.
Highlights
Dysfunction of the thyroid gland, hyperfunction or hypofunction, is frequently associated with mental disorders including psychoses that sometimes resemble schizophrenia [1]
The FT4 concentration was higher in the patients who were not taking an antipsychotic drug on admission (P=0.039)
No significant correlation was found between the severity of psychosis and concentrations of thyroid axis hormones
Summary
Dysfunction of the thyroid gland, hyperfunction or hypofunction, is frequently associated with mental disorders including psychoses that sometimes resemble schizophrenia [1]. An increased prevalence of thyroid function abnormalities has been reported in families of patients with schizophrenia [2], suggesting a possible genetic linkage between the endocrine and mental disorders. It is well known that illness, certainly including mental illness, may activate the thyroid axis, and this activation is often noted when patients are admitted to the hospital. Several studies have reported the elevated serum concentrations of thyroxine (T4), but not triiodothyronine (T3), in acute psychiatric disorders, an abnormality that usually resolves during recovery and is called transient hyperthyroxinemia [5, 6]. The data on the frequency of this activation, the factors that may modify it, and associated
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