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Thyroid function screening of psychiatric inpatient admissions: a worthwhile procedure?
Journal of the Royal Society of Medicine
|February 1, 1987
Summary
A thyroid function screening program in psychiatric admissions found few unsuspected thyroid diseases. The low detection rate suggests a formal screening program is not warranted for these patients.
Area of Science:
- Psychiatry
- Endocrinology
- Clinical Medicine
Background:
- Thyroid dysfunction is common and can mimic psychiatric symptoms.
- Screening for thyroid dysfunction in psychiatric populations is debated.
Purpose of the Study:
- To evaluate the effectiveness of a thyroid function screening program for new admissions to a general psychiatric service.
- To determine the yield of unsuspected thyroid disease in this population.
Main Methods:
- A prospective screening program was implemented over 22 weeks.
- Thyroid function tests were performed on psychiatric admissions.
- Abnormal results were followed up with further investigations.
Main Results:
- A 57.1% screening rate was achieved among 588 admissions.
- 21.3% had initial thyroxine levels outside the normal range.
- Only 9 patients (1.5%) had confirmed thyroid disease, with 7 clinically suspected. Only 2 unsuspected cases were found.
Conclusions:
- The low detection rate of unsuspected thyroid dysfunction does not justify a formal screening program in this setting.
- Clinical suspicion remains a key factor in diagnosing thyroid disease in psychiatric patients.