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Thyroid abnormalities associated with rapid-cycling bipolar illness.

R W Cowdry, T A Wehr, A P Zis

    Archives of General Psychiatry
    |April 1, 1983
    PubMed
    Summary
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    Rapid-cycling bipolar disorder patients taking lithium carbonate frequently develop hypothyroidism. Thyroid axis abnormalities may contribute to rapid cycling and explain thyroid treatment efficacy in these patients.

    Area of Science:

    • Psychiatry
    • Endocrinology
    • Pharmacology

    Background:

    • Bipolar disorder is a mood disorder characterized by shifts in mood, energy, and activity levels.
    • Lithium carbonate is a common mood stabilizer for bipolar disorder.
    • Rapid-cycling bipolar disorder is defined by four or more mood episodes within a 12-month period.

    Purpose of the Study:

    • To investigate the prevalence of thyroid dysfunction in rapid-cycling versus non-rapid-cycling bipolar patients treated with lithium carbonate.
    • To explore the relationship between thyroid axis abnormalities and the rapid-cycling phenotype in bipolar disorder.

    Main Methods:

    • Classification of bipolar patients into rapid-cycling and non-rapid-cycling groups based on episode frequency.
    • Assessment of overt hypothyroidism and elevated thyroid-stimulating hormone (TSH) levels in both groups.

    Related Experiment Videos

  • Analysis of hypothalamic-pituitary-thyroid axis function in relation to lithium treatment and cycling patterns.

    • Main Results:

    • Overt hypothyroidism was diagnosed in 50.7% of rapid-cycling patients versus 0% of non-rapid-cycling patients.
    • Elevated TSH levels were found in 92% of the rapid-cycling group compared to 32% in the non-rapid-cycling group.
    • Thyroid axis abnormalities, potentially unmasked by lithium, appear linked to rapid-cycling bipolar disorder.

    Conclusions:

    • Thyroid dysfunction is significantly more common in rapid-cycling bipolar patients treated with lithium.
    • Abnormalities in the hypothalamic-pituitary-thyroid axis may play a role in the pathophysiology of rapid-cycling bipolar disorder.
    • These findings support the use of thyroid treatments for periodic catatonia and rapid-cycling bipolar disorder.