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Thyroid function in anxious and depressed patients.

M L Rao1, D Vartzopoulos, K Fels

  • 1Department of Psychiatry, University of Bonn, FRG.

Pharmacopsychiatry
|March 1, 1989
PubMed
Summary
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Thyroid hormone levels and thyrotropin (TSH) responses to TRH were altered in psychiatric inpatients. These thyroid function tests, along with dexamethasone suppression tests, show potential for diagnosing major depression and anxiety disorders.

Area of Science:

  • Neuroendocrinology
  • Psychiatry

Background:

  • Thyroid dysfunction is linked to mood and anxiety disorders.
  • Previous research suggests alterations in thyroid hormones and TSH response in psychiatric conditions.

Purpose of the Study:

  • To investigate thyroid hormone levels and TSH response to TRH in psychiatric inpatients.
  • To evaluate the diagnostic utility of TRH and dexamethasone suppression tests in major depression, anxiety disorder, and anxious depression.

Main Methods:

  • Measured serum thyroid hormones (triiodothyronine, thyroxine) and thyrotropin (TSH) before and after TRH administration.
  • Assessed cortisol levels pre- and post-dexamethasone administration.
  • Compared results between 46 psychiatric inpatients (major depression, anxiety disorder, anxious depression) and 56 healthy controls.

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Main Results:

  • Lower basal triiodothyronine in female patients with major depression and anxious depression.
  • Lower basal thyroxine in female patients with anxious depression.
  • All patient groups exhibited lower basal TSH compared to controls.
  • A blunted TSH response to TRH was observed in a significant percentage of female patients.
  • Combined TRH and dexamethasone tests showed varying sensitivities for different psychiatric diagnoses (45-65%).

Conclusions:

  • Alterations in thyroid hormone levels and TSH regulation are present in patients with major depression and anxiety disorders.
  • TRH and dexamethasone suppression tests demonstrate potential as adjunctive diagnostic tools for these conditions.
  • Further research is warranted to elucidate the specific roles of thyroid hormones and HPA axis dysregulation in psychiatric disorders.