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Comprehensive Thyroid Evaluation in Psychiatric Patients

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Handbook of Psychiatric Diagnostic Procedures Vol. I

Abstract

The thyroid gland is one link in the neuroendocrine system known as the Hypothalamic-Pituitary-Thyroid (HPT) axis [1–3]. Within this axis, circulating thyroid hormones are tightly regulated by both central nervous system input and peripheral feedback control. The hypothalamus secretes Thyrotropin Releasing Hormone (TRH) into the portal system of the adenohypophysis. TRH stimulates the pituitary thyrotrope cells to release Thyroid Stimulating Hormone (TSH), which in turn increases the rates of iodide uptake, hormone synthesis, and release of thyroxine (T4) and triiodothyronine (T3).

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References

  1. Demeester-Mirkline N, Dumont JE: The hypothalama-pituitary-thyroid axis. In DeVisscher M (ed): The Thyroid Gland. New York, Raven Press, 1980.

    Google Scholar 

  2. Martin JB, Reichlin S, Brown GM: Clinical Neuroendocrinology. Philadelphia, FA Davis Company, 1977.

    Google Scholar 

  3. Morley JE: Neuroendocrine control of thyrotropin secretion. Endocr Rev 2: 396–436, 1981.

    Article  PubMed  CAS  Google Scholar 

  4. Martin JB, Boshans R, Reichlin S: Feedback regulation of TSH secretion in rats with hypothalamic lesions. Endocrinology 87:1032–1040, 1970.

    Article  PubMed  CAS  Google Scholar 

  5. Wilber JF, Porter JC: Thyrotropin and growth hormone releasing activity in hypophysial portal blood. Endocrinology 87:807–811, 1970.

    Article  PubMed  CAS  Google Scholar 

  6. Jackson IMD: Thyrotropin-releasing hormone. N Eng J Med 306:145–153, 1982.

    Article  CAS  Google Scholar 

  7. Hokfelt T, Fuxe K, Johansson O, et al: Distribution of thyrotropin-releasing hormone (TRH) in the central nervous system as revealed with immunochemistry. Eur J Pharmacol 34:389–392, 1975.

    Article  PubMed  CAS  Google Scholar 

  8. Hokfelt T, Johansson O, Ljungdahl A, et al: Neurotransmitting and neuropeptides: distribution patterns and cellular localization as revealed by immuno-cytochemistry. In Nobel Symposium, 42d Stockholm, 1978. Central Regulation of the Endocrine System. New York, Plenum Press, 1979.

    Google Scholar 

  9. Jackson IMD, Reichlin S: Brain thyrotropin-releasing hormone is independent of the hypothalamus. Nature 267:853–854, 1977.

    Article  PubMed  CAS  Google Scholar 

  10. Renaud LP, Martin JB: Thyrotropin-releasing hormone (TRH): depressant action on central neuronal activity. Brain Res 86:150–154, 1975.

    Article  PubMed  CAS  Google Scholar 

  11. Braitman DJ, Auker CR, Carpenter DO: Thyrotropin-releasing hormone has multiple actions in cortex. Brain Res 194:244–248, 1980.

    Article  PubMed  CAS  Google Scholar 

  12. Porter CC, Lotti VJ, DeFelice J: The effect of TRH and a related tripeptide, L-N-(2-oxopiperidin-6-yl-carbonyl)-L-histidyl-L-thiazolidine-4-carboxamide (MK-771, OHT), on the depressant action of barbiturates and alcohol in mice and rats. Life Sci 21:811–820, 1977.

    Article  PubMed  CAS  Google Scholar 

  13. Stanton TL, Beckman AL, Winokur A: Thyrotropin-releasing hormone effects in the central nervous system: Dependence on arousal state. Science 214:678–681, 1981.

    Article  PubMed  CAS  Google Scholar 

  14. Costall B, Hui S-CG, Metcalf G, et al: A study of the changes in motor behavior caused by TRH on intracerebral injection. Euro J Pharmacol 53:143–150, 1979.

    Article  CAS  Google Scholar 

  15. Constantinidis J, Geissbuhler F, Gaillard JM: Enhancement of Cerebral noradrenaline turnover by thyrotropin-releasing hormone: evidence by fluorescence histochemistry. Experientia 30:1182–1183, 1974.

    Article  PubMed  CAS  Google Scholar 

  16. Kastin AJ, Ehrensing RH, Schalcn DS, et al: Improvement in mental depression with decreased thyroid response after administration of thyrotropin-releasing hormone. Lancet 2:740–742, 1972.

    Article  PubMed  CAS  Google Scholar 

  17. Ehrensing RH, Kastin AJ, Schalch DS, et al: Affective states and thyrotropin and prolactin responses after repeated injections of thyrotropin-releasing hormone in depressed patients. Am J Psychiatry 131:714–718, 1974.

    PubMed  CAS  Google Scholar 

  18. Grimm Y, Reichlin S: Thyrotropin-releasing hormone (TRH): Neurotransmitter regulation of secretion by mouse hypothalamic tissue in vitro. Endocrinology 93:626–631, 1973.

    Article  PubMed  CAS  Google Scholar 

  19. Gold PW, Goodwin FK, Wehr T, et al: Pituitary thyrotropin response to thyrotropin-releasing hormone in affective illness: Relationship to spinal fluid amine metabolites. Am J Psychiatry 134:1028–1031, 1977.

    PubMed  CAS  Google Scholar 

  20. Whybrow PC, Prange AJ: A hypothesis of thyroid-catecholamine-receptor interaction: Its relevance to affective illness. Arch Gen Psychiatry 38:106–113, 1981.

    Article  PubMed  CAS  Google Scholar 

  21. Roti E, Christianson D, Harris AC, et al: “Short” loop feedback regulation of hypothalamic and brain thyrotropin-releasing hormone content in the rat and dwarf mouse. Endocrinology 103:1662–1667, 1978.

    Article  PubMed  CAS  Google Scholar 

  22. Okuno A, Taguchi T, Nakayama K, et al: Kinetic analysis of plasma TSH dynamics after TRH stimulation. Horm Metab Res 11:293–295, 1979.

    Article  PubMed  CAS  Google Scholar 

  23. Vanhaelst L, Van Cauter E, Degaute JP, et al: Orcadian variations of serum thyrotropin levels in man. J Clin Endocrinol Metab 35:479–482, 1972.

    Article  PubMed  CAS  Google Scholar 

  24. Grant G, Vale W, Guillemin R: Interaction of thyrotropin-releasing factor with membrane receptors of pituitary cells. Biochem Biophys Res Commun 46:28–34, 1972.

    Article  PubMed  CAS  Google Scholar 

  25. Larsen PR: Thyroid-pituitary interaction: feedback regulation of thyrotropin secretion by thyroid hormones. N Eng J Med 306:23–32, 1982.

    Article  CAS  Google Scholar 

  26. Sowers JR, Carlson HE, Brautbar N, et al: Effect of dexamethasone on prolactin and TSH responses to TRH and metoclopramide in man. J Clin Endocrinol Metab 44:237–241, 1977.

    Article  PubMed  CAS  Google Scholar 

  27. Re RN, Kourides IA, Ridgway EC, et al: The effect of glucocorticoid administration in human pituitary secretion of thyrotropin and prolactin. J Clin Endocrinol Metab 43:338–346, 1976.

    Article  PubMed  CAS  Google Scholar 

  28. Siler TM, Yen SSC, Vale W, et al: Inhibition by somatostatin on the release of TSH induced in man by thyrotropin-releasing factor. J Clin Endocrinol Metab 38:742–745, 1974.

    Article  PubMed  CAS  Google Scholar 

  29. Ingbar SH, Woeber KA: The thyroid gland. In Williams RH (ed): Textbook of Endocrinology. Philadelphia, WB Saunders Company, 1974.

    Google Scholar 

  30. Blum M: Easier understanding of the new thyroid tests. Resident and Staff Physician 27:72–90, 1981.

    Google Scholar 

  31. Warren DW, LoPresti S, Nicoloff JT: A new method for measurement of the conversion ratio of thyroxine to triiodothyronine in euthryoid man. J Clin Endocrinol Metab 53:1218–1222, 1981.

    Article  PubMed  CAS  Google Scholar 

  32. Taylor F: Iodine: going from hypo to hyper. FDA Consumer 15-18, 1981.

    Google Scholar 

  33. Ingbar SH, Woeber KA: The thyroid gland In Williams RH (ed): Textbook of Endocrinology. Philadelphia, Saunder, 129–131, 1981.

    Google Scholar 

  34. Ormston BJ, Garry R, Cryer RJ, et al: Thyrotropin-releasing hormone as a thyroid-function test. Lancet 2:10–14, 1971.

    Article  PubMed  CAS  Google Scholar 

  35. Fink JN, Beall GN: Immunologic aspects of endocrine disease. JAMA 248: 2696–2700, 1982.

    Article  PubMed  CAS  Google Scholar 

  36. Fournier C, Chen HP, Leger A, et al: T cell functions in autoimmune thyroid diseases. Hormone Res 16 (No 5) Sept-Oct.:348, 1982.

    Google Scholar 

  37. Hawkins BR, Dawkins RL, Burger HG, et al: Diagnostic significance of thyroid microsomal antibodies in randomly selected population. Lancet 2:1057–1059, 1980.

    Article  PubMed  CAS  Google Scholar 

  38. Gordon A, Maatela J, Miettinen A, et al: Serum thyrotropin and circulating thyroglobulin and thyroid microsomal antibodies in a Finnish population. Acta Endocrinologica 90:33–42, 1979.

    Google Scholar 

  39. Whybrow PC, Prange AJ, Treadway CR: Mental changes accompanying thryoid gland dysfunction: A reappraisal using objective psychological measurement. Arch Gen Psychiatry 20:48–63, 1969.

    Article  PubMed  CAS  Google Scholar 

  40. Haskett RF, Rose RM: Neuroendocrine disorders and psychopathology. Psychiatr Clin North Am 4:239–252, 1981.

    PubMed  CAS  Google Scholar 

  41. Gold MS, Pottash ALC, Extein I, et al: Diagnosis of depression in the 1980’s. JAMA 245:1562–1564, 1981.

    Article  PubMed  CAS  Google Scholar 

  42. Diagnostic and Statistical Manual of Mental Disorders (3rd edition). Washington, DC, American Psychiatric Association, 1980.

    Google Scholar 

  43. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders. New York, New York State Psychiatric Institute, 1980.

    Google Scholar 

  44. Skodol AE, Spitzer RL: The development of reliable diagnostic criteria in psychiatry. Ann Rev Med 33:317–326, 1982.

    Article  PubMed  CAS  Google Scholar 

  45. Billewicz WZ, Chapman RS, Crooks J, et al: Statistical methods applied to the diagnosis of hypothyroidism. Q J Med 150:255–266, 1969.

    Google Scholar 

  46. Evered DC, Ormston BJ, Smith PA, et al: Grades of hypothyroidism. Br Med J 1:657–662, 1973.

    Article  PubMed  CAS  Google Scholar 

  47. Harvey RF: Grades of hypothyroidism (let). Br Med J 2:488–489, 1973.

    Article  PubMed  CAS  Google Scholar 

  48. Bastenie PA, Bonnyns M, Vanhaelst L: Grades of subclinical hypothyroidism in asymptomatic autoimmune thyroiditis revealed by the thyrotropin-releasing hormone test. J Clin Endocrinol Metab 51:163–166, 1980.

    Article  PubMed  CAS  Google Scholar 

  49. Wenzel KW, Meinhold H, Raffenberg M, et al: Classification of hypothyroidism in evaluating patients after radioiodine therapy by serum cholesterol, T3-UP-take, total T4, FT4-index, total T3, basal TSH and TRH-test. Eur J Clin Invest 4:141–148, 1974.

    PubMed  CAS  Google Scholar 

  50. Prange AJ, Lara PP, Wilson IC: Effects of thyrotropin-releasing hormone in depression. Lancet 2:999–1002, 1972.

    Article  PubMed  Google Scholar 

  51. Targum SD, Sullivan AC, Byrnes SM: Compensatory pituitary-thyroid mechanisms in major depressive disorder. Psychiatry Res 6:85–96, 1982.

    Article  PubMed  CAS  Google Scholar 

  52. Kirkegaard C, Bjorum N: TSH responses to TRH in endogenous depression (let). Lancet 1:152, 1980.

    Article  PubMed  CAS  Google Scholar 

  53. Prange AJ, Loosen PT: Some endocrine aspects of affective disorders. J Clin Psychiatry 41:29–34, 1980.

    PubMed  Google Scholar 

  54. Gold MS, Pottash ALC, Extein I, et al: The TRH test in the diagnosis of major and minor depression. Psychoneuroendocrinology 6:159–169, 1981.

    Article  PubMed  CAS  Google Scholar 

  55. Ettigi PG, Brown GM: Psychoneuroendocrinology of affective disorder: An overview. Am J Psychiatry 134:493–501, 1977.

    PubMed  CAS  Google Scholar 

  56. Sternbach H, Gerner RD, Gwirtsman HE: The thyrotropin-releasing hormone stimulation test: A review. J Clin Psychiatry 43:4–6, 1982.

    PubMed  CAS  Google Scholar 

  57. Gold MS, Pottash ALC, Ryan N, et al: TRH-induced TSH response in unipolar, bipolar and secondary depressions: Possible utility in clinical assessment and differential diagnosis. Psychoneuroendocrinology 5:147–155, 1980.

    Article  PubMed  CAS  Google Scholar 

  58. Extein I, Pottash ALC, Gold MS et al: The thyroid-stimulating hormone response to thyrotropin-releasing hormone in mania and bipolar depression. Psychiatry Res 2:199–204, 1980.

    Article  PubMed  CAS  Google Scholar 

  59. Linkowski P, Brauman H, Mendlewicz J: Thyrotropin response to thyrotropin-releasing hormone in unipolar and bipolar affective illness. J Affective Disord 3:9–16, 1981.

    Article  CAS  Google Scholar 

  60. Kirkegaard C, Bjorum N, Cohn D, et al: Studies on the influence of biogenic amines and psychoactive drugs on the prognostic value of theTRH stimulation test in endogenous depression. Psychoneuroendocrinology 2:131–136, 1977.

    Article  PubMed  CAS  Google Scholar 

  61. Gold MS, Pottash ALC, Extein I: Hypothyroidism and depression: evidence from complete thyroid function evaluation. JAMA 245:1919–1922, 1981.

    Article  PubMed  CAS  Google Scholar 

  62. Sternbach HA, Gold MS, Pottash ALC, et al: Thyroid failure and protirelin (thyrotropin-releasing hormone) test abnormalities in depressed outpatients. JAMA 245:1618–1620, 1983.

    Article  Google Scholar 

  63. Bonnyns M, Vanhaelst L, Bastenie PA: Asymptomatic atrophic thyroiditis. Horm Res 16:338–344, 1982.

    Article  PubMed  CAS  Google Scholar 

  64. Gold MS, Pottash ALC, Extein I: “Symptomless” autoimmune thyroiditis in depression. Psychiatry Res 6:261–269, 1982.

    Article  PubMed  CAS  Google Scholar 

  65. Bastenie PA, Vanhaelst L, Bonnyns M, et al: Preclinical hypothyroidism: A risk factor for coronary-heart disease. Lancet 1:203–204, 1971.

    Article  PubMed  CAS  Google Scholar 

  66. Ridgway EC, Cooper DS, Walker H, et al: Peripheral responses to thyroid hormone before and after L-thyroxine therapy in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 53:1238–1242, 1981.

    Article  PubMed  CAS  Google Scholar 

  67. Prange AJ, Wilson IC, Rabon AM, et al: Enhancement of imipramine antidepressant activity by thyroid hormone. Am J Psychiatry 126:457–469, 1969.

    PubMed  CAS  Google Scholar 

  68. Wilson IC, Prange AJ, McClane K, et al: Thyroid-hormone enhancement of imipramine in nonretarded depressions. N Eng J Med 282:1063–1067, 1970.

    Article  CAS  Google Scholar 

  69. Wheatley D: Potentiation of amitriptyline by thyroid hormone. Arch Gen Psychiatry 26:229–233, 1972.

    Article  PubMed  CAS  Google Scholar 

  70. Earle BV: Thyroid hormone and tricyclic antidepressants in resistant depressions. Am J Psychiatry 126:143–145, 1970.

    Google Scholar 

  71. Whybrow PC, Coppen A, Prange AJ, et al: Thyroid function and the response to liothyronine in depression. Arch Gen Psychiatry 26:242–245, 1972.

    Article  PubMed  CAS  Google Scholar 

  72. Hall RCW, Gardner ER, Stickney SK, et al: Physical illness manifesting as psychiatric disease. II. Analysis of a state hospital inpatient population. Arch Gen Psychiatry 37:989–995, 1980.

    Article  PubMed  CAS  Google Scholar 

  73. Carney MWP, Macleod S, Sheffield BF: Thyroid function screening in psychiatric inpatients. Br J Psychiatry 138:154–156, 1981.

    Article  PubMed  CAS  Google Scholar 

  74. Josephson AM, MacKenzie B: Appearance of manic psychosis following rapid normalization of thyroid status. Am J Psychiatry 136:846–847, 1979.

    PubMed  CAS  Google Scholar 

  75. Josephson AM, MacKenzie B: Thyroid-induced mania in hypothyroid patients. Br J Psychiatry 137:222–228, 1980.

    Article  PubMed  CAS  Google Scholar 

  76. Kronfol Z, Grenen JF, Condon M, et al: Application of biological markers in depression secondary to thyrotoxicosis. Am J Psychiatry 139:1319–1322, 1982.

    PubMed  CAS  Google Scholar 

  77. Extein I, Pottash ALC, Gold MS, et al: Differentiating mania from schizophrenia by the TRH test. Am J Psychiatry 137:981–982, 1980.

    PubMed  CAS  Google Scholar 

  78. Extein I, Pottash ALC, Gold MS, et al: Using the protirelin test to distinguish mania from schizophrenia. Arch Gen Psychiatry 39:77–81, 1982.

    Article  PubMed  CAS  Google Scholar 

  79. Gold MS, Byck R: Endoprhins, lithium and naloxone: Their relationship to pathological and drug-induced manic-euphoric states. In Peterson RC (ed): The International Challenge of Drug Abuse, Monograph 19. Rockville, MD, National Institute on Drug Abuse, 1978.

    Google Scholar 

  80. Temple R, Berman M, Robbins J, et al: The use of lithium in the treatment o of thyrotoxicosis. J Clin Invest 51:2746–2756, 1972.

    Article  PubMed  CAS  Google Scholar 

  81. Schildkraut JJ: The catecholamine hypothesis of affective disorders: A review of supporting evidence. Am J Psychiatry 122:509–522, 1965.

    PubMed  CAS  Google Scholar 

  82. Davis JM: Overview: maintenance therapy in psychiatry: II. Affective disorders. Am J Psychiatry 133:1–13, 1976.

    PubMed  CAS  Google Scholar 

  83. Reisberg B, Gershon S: Side effects associated with lithium therapy. Arch Gen Psychiatry 36:879–887, 1979.

    Article  PubMed  CAS  Google Scholar 

  84. Peselow E, Lautin A, Gershon S: Prophylactic and therapeutic profile of lithium. Bibl Psychiatr 161:1–31, 1981.

    PubMed  Google Scholar 

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  1. Mark S. Gold
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  2. Michael H. Kronig
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Gold, M.S., Kronig, M.H. (1984). Comprehensive Thyroid Evaluation in Psychiatric Patients. In: Handbook of Psychiatric Diagnostic Procedures Vol. I. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-6725-3_2

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  • DOI: https://doi.org/10.1007/978-94-011-6725-3_2

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-6727-7

  • Online ISBN: 978-94-011-6725-3

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