Related Experiment Videos
Thyroid disease and mental illness: a study of thyroid disease in psychiatric admissions
1University Department of Psychiatry, Royal South Hants Hospital, Southampton, U.K.
Insights
Thyroid disease screening in psychiatric patients has questionable value, though it
Area of Science:
- Psychiatry
- Endocrinology
- Medical Diagnostics
Background:
- Routine thyroid function tests are sometimes performed in psychiatric admissions.
- The prevalence and clinical significance of thyroid dysfunction in this population are not fully established.
Observation:
- Thyroid function tests were performed on 300 of 1007 psychiatric admissions.
- Abnormal results were found in 3.3% of tested admissions, primarily in patients with affective disorder.
- Two new cases of hypothyroidism were identified, presenting solely with mental illness symptoms.
Findings:
- Seven patients (2.3%) had sustained thyroid abnormalities, with five having a known history.
- Thyroid disease was considered a precipitating factor for mental illness in five cases.
- All sustained abnormalities, except one, occurred in female patients.
Implications:
- Widespread thyroid screening in psychiatric patients may not be cost-effective.
- Targeted screening in specific subgroups (e.g., female patients with affective disorder, those with thyroid history) could be more efficient.
- Early diagnosis of thyroid disease contributing to mental illness is crucial for effective treatment.
Abstract:
The notes of 1007 consecutive admissions to a District General Hospital adult psychiatry unit were examined retrospectively to establish the role of the thyroid disease detected in routine management. Thyroid function tests were performed on 300 admissions, leaving 707 untested. Ten had abnormal results (3.3% of admissions tested), accounted for by nine patients with affective disorder. Two of the nine settled spontaneously, but seven cases (2.3%) had sustained abnormality. Five of the seven had a known history of thyroid disease, leaving two new findings of hypothyroidism who presented with no clinical signs other than their mental illness (0.7% of admissions tested). In five cases, which included the two new findings, the thyroid disease had been judged to precipitate the mental illness. All cases except one transitory abnormality occurred in females. When the results of this and other surveys are compared with the figures for thyroid disease in the general population, the value of screening psychiatric patients seems questionable. However, diagnosis is important in a few cases where thyroid disease apparently contributes to the mental illness. For psychiatric patients aged up to 65, elimination of unnecessary thyroid function tests without sacrificing detection may be possible by restricting use to female patients with affective disorder, patients with a past or family history of thyroid disease or with presenile dementia. Abnormal results obtained during the acute phase of the illness may be transitory and require confirmation.