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Euthyroid hyperthyroxinaemia in acute psychiatric admissions.

T J Lambert¹, R Davidson, G H McLellan

¹Clinical Research Unit, Greylands Hospital, Claremont, WA.

The Australian and New Zealand Journal of Psychiatry

|December 1, 1987

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Transient elevations in serum thyroxine (T4) levels were observed in psychiatric patients. These findings suggest careful interpretation of thyroid function tests during acute psychiatric admissions.

Area of Science:

Psychiatry
Endocrinology
Clinical Chemistry

Background:

Thyroid dysfunction is common in psychiatric patients.
Elevated serum thyroxine (T4) levels can occur transiently in certain clinical settings.

Purpose of the Study:

To investigate the incidence and characteristics of transient hyperthyroxinemia in patients admitted to a psychiatric ward.
To determine if transient hyperthyroxinemia in psychiatric admissions requires further thyroid function testing.

Main Methods:

Prospective study of 98 patients admitted to a psychiatric ward.
Serial testing of serum thyroxine (T4) levels at admission, day five, and day fourteen.
Clinical assessment for thyrometabolic disorders.

Main Results:

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13% of patients showed initial transient elevation of serum T4 (142-174 nmol/l).
Incidence increased to 15% on serial testing.
No clinical evidence of thyroid disorder was found, and hyperthyroxinemia normalized rapidly.

Conclusions:

Transient hyperthyroxinemia is a potential finding in acute psychiatric admissions.
Routine thyroid function tests in this population require careful interpretation.
Clinical evaluation remains paramount for diagnosing thyroid disorders.