A study of thyroid dysfunction in Nigerian psychiatric outpatients

Area of Science:

• Endocrinology
• Psychiatry
• Clinical Diagnostics

Background:

• Thyroid hormones, thyroxine (T) and triiodothyronine (T3), play a critical role in regulating metabolism and neurological function.
• Thyroid dysfunction can manifest with a wide range of psychiatric symptoms, potentially leading to misdiagnosis or delayed treatment.
• The prevalence of thyroid abnormalities in psychiatric patient populations requires further investigation to inform clinical screening protocols.

Purpose of the Study:

• To determine the prevalence of abnormal serum total thyroxine (T) and triiodothyronine (T3) concentrations in psychiatric outpatients.
• To assess the clinical significance of thyroid dysfunction in patients presenting with psychiatric symptoms.
• To evaluate the necessity of thyroid function screening in psychiatric patients, particularly those over 40 years of age.

Main Methods:

• A cohort of 1,584 consecutive outpatients from the Department of Psychiatry, Ahmadu Bello University Hospital, Kaduna, were included in the study.
• Serum thyroid hormone levels (T and T3) were quantified using the enzyme-linked immunosorbent assay (ELISA) technique.
• Patients were assessed for both laboratory-confirmed thyroid dysfunction and clinical presentation of thyroid disorders.

Main Results:

• A prevalence of 0.2% for primary hypothyroidism was observed in three female patients.
• A prevalence of 0.6% for hyperthyroidism was diagnosed in nine patients.
• Five patients, initially classified as euthyroid by laboratory tests, exhibited clinical signs of hyperthyroidism, with two cases occurring during the puerperium.

Conclusions:

• Thyroid dysfunction, including hypothyroidism and hyperthyroidism, is present in a notable proportion of psychiatric outpatients.
• Clinical assessment is essential, as some patients may present with thyroid dysfunction despite normal laboratory results.
• Routine screening for thyroid dysfunction is recommended for all psychiatric patients over 40 years old to ensure comprehensive care.