[Thyroid gland disorders in elderly psychiatric patients]

With 200 admissions of 192 patients to the psychogeriatric acute ward of the Zwiefalten State Mental Hospital serial measurements of serum concentrations of basal TSH and, if necessary, of total T3 and total T4 were carried out with the TRH tests performed. Basal TSH was decreased in 16% of patients and in 2% it was increased. Only three patients had manifest hyperthyroidism and one patient had marginal hypothyroidism. Regardless of their psychiatric diagnosis, patients with manifest hyperthyroidism showed psychomotor agitation, whereas those with latent and marginal hypothyroidism suffered from lack of impulse. These symptoms improved after treatment with carbimazol or levothyroxine, respectively, and psychotropic drugs. Therefore a thyroid screening should be performed on psychogeriatric patients regardless, including, when possible, repeat measurement of basal TSH and, if necessary, the test battery should include total T3 and total T4.