Thyroid function screening in psychiatric patients

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Abstract
Abnormalities in levels of total thyroxine [T4] and T4 binding capacity were common in a group of 480 newly admitted psychiatric patients. The estimated free T4 (EFT4) level was elevated in 43 patients (9%). In 27 of these patients, the level of EFT4 became spontaneously normal, usually within a 2 wk period (acute stress hyperthyroidism). The level of EFT4 was decreased in 42 patients (9%). In 16 of these patients, the level became spontaneously normal; the etiology of this apparent acute hypothyroidism is unclear. The yield of new cases of primary hyperthyroidism and hypothyroidism was low, but a presumptive diagnosis of secondary hypothyroidism was made in 8 patients. In addition, 9 patients with known thyroid disease were taking inadequate or excessive replacement therapy. Thyroid function screening tests are of value in psychiatric patients.

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