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Euthyroid sick syndrome in psychiatric inpatients
1Department of Medicine, University of Texas Medical School, Houston, USA.
Biological Psychiatry
|December 15, 1996
Summary
Euthyroid sick syndrome (ESS) is common in psychiatric inpatients, affecting 10.2%. Thyroid function abnormalities like hyperthyroxinemia (HT) and elevated thyroid-stimulating hormone (HTSH) are linked to specific psychiatric diagnoses.
Area of Science:
- Endocrinology
- Psychiatry
- Internal Medicine
Background:
- Euthyroid sick syndrome (ESS) is frequently observed in various medical conditions.
- Understanding ESS prevalence and associations in psychiatric populations is crucial for patient care.
Purpose of the Study:
- To determine the incidence and characteristics of ESS in a large cohort of psychiatric inpatients.
- To investigate the relationship between specific thyroid function abnormalities within ESS and psychiatric diagnoses.
Main Methods:
- Retrospective analysis of 3188 psychiatric inpatients' medical records.
- Defined strict criteria for ESS, categorizing patients by thyroid status: hyperthyroxinemic (HT), hypothyroxinemic, elevated TSH (HTSH), and suppressed TSH.
- Utilized DSM-III-R discharge diagnoses and chi-squared tests to analyze associations.
Main Results:
- ESS was identified in 10.2% (324/3188) of patients.
- Hyperthyroxinemia (HT) was observed in 95 patients, and mildly elevated TSH (HTSH) in 179 patients.
- HT and HTSH frequencies significantly differed across psychiatric categories (p < .05 and p < .01, respectively), with HT highest in mood disorders and HTSH highest in substance abuse disorders.
Conclusions:
- ESS, particularly HT and HTSH, is prevalent in psychiatric inpatients.
- The observed associations suggest that pathophysiologic mechanisms of ESS may be influenced by the underlying psychiatric diagnosis.
- Further research is warranted to explore these specific pathophysiologic links.