Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T16:48:22.706Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of thyroid function in lithium-naive bipolar patients

Published online by Cambridge University Press:  16 April 2020

J. Valle ,
J.L. Ayuso-Gutierrez ,
A. Abril  and
J.L. Ayuso-Mateos
J. Valle
Affiliation:
Department of Psychiatry, Hospital de la Princesa, Madrid
J.L. Ayuso-Gutierrez
Affiliation:
Department of Psychiatry, Complutense University, Madrid
A. Abril
Affiliation:
Department of Psychiatry, Complutense University, Madrid
J.L. Ayuso-Mateos*
Affiliation:
Clinical and Social Psychiatry Research Unit, University of Cantabria, Santander, Spain
*
*Correspondence and reprints Mailing address: Clinical and Social Psychiatry Research Unit, Hospital Universitario Marqués de Valdecilla, Avd Valdecilla s/n, Santander 39008, Spain
Get access

Summary

A high prevalence of thyroid hypofunction has been found in bipolar patients. However, the samples used in previous studies included a high percentage of patients in treatment with lithium and carbamazepine. Since the use of these drugs may explain the high prevalence of thyroid disturbances found in bipolar patients, we designed the present study to assess thyroid function in a sample of bipolar patients who had not been treated previously with lithium or carbamazepine. Patients included in the sample met Research Diagnostic Criteria for bipolar affective disorder. Assessment included determination of serum levels for total tyroxine (T4), total triiodothyronine (T3), and thyrotropin both basally and in response to infusion of 500 mg of Protilerin. The rate of thyroid hypofunction in the total sample (9.2%) was considerably lower than that reported in other studies with bipolar patients undergoing lithium therapy. Five patients (9.2%) showed some thyroid hyperfuncion parameter. Our results do not show significant differences in thyroid function indices between long-term and short-term duration of illness, between outpatients and inpatients, between high and low number of episodes, and between rapid- and non-rapid-cycling cases. Comparison between bipolar I and bipolar II patients shows a statistically significant difference in the values of TSH levels, with the bipolar II group having a higher mean value. Our data suggest that thyroid dysfunction is not related to gender, duration of illness, number of episodes, or rapid-cycling course of illness. The higher TRH-stimulated TSH levels in the bipolar II group could be considered a differential biological feature.

Keywords

bipolar disorderlithiumthyroid function
Type
Original article
Information
European Psychiatry , Volume 14 , Issue 6 , October 1999 , pp. 341 - 345
Copyright
Copyright © European Psychiatric Association 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altshuler, LLCurran, JGHauser, PMintz, JDenicoff, KPost, R, et al. T2 hyperintensities in bipolar disorder: magnetic reso- nance imaging comparison and literature meta-analysis Am J Psychiat 1995 ; 152 : 1139-44.Google Scholar
Bartalena, LPellegrini, LMeschi, MAntonangeli, LBogazzi, FDell’Osso, L, et al. Evaluation of thyroid function in patients with rapid-cycling and non-rapid-cycling bipolar disorder Psychiat. Res. 1990 ; 34 : 13–17.CrossRefGoogle ScholarPubMed
Bauer, MSWhybrow, PC. Thyroid hormones and the central nervous system in affective illness: Interactions that may have clinical significance Integrat Psychiatry 1988 ; 6 : 75–100.Google Scholar
Bauer, MSWhybrow, PCWinokur, A. Rapid cycling bipolar affective disorder. I Association with grade I hypothyroidism Arch Gen Psychiat 1990 ; 47 : 427-32.CrossRefGoogle ScholarPubMed
Beckman, HGoodwin, FK. MHPG excretion in depressive patients and normal controls 2nd world Congress of Biological Psychiatry, 1978. p. 140.Google Scholar
Coryell, WEndicott, JKeller, M. Rapidly cycling affective disorder: demographics, diagnosis, family history and course Arch Gen Psychiat 1992 ; 49 : 126-31.CrossRefGoogle ScholarPubMed
Cowdry, RWWehr TA, Zis, AP, et al. Thyroid abnormalities associated with rapid cycling bipolar illness Arch Gen Psychiat 1983 ; 40 : 414-20.CrossRefGoogle ScholarPubMed
Dixon, WJBrown, MBEngelman, L. BMDP Statistical Software Manual Berkeley : University of California Press ; 1990. p. ?–?.Google Scholar
Dunner, DLFieve, RR, Clinical factors in lithium carbonate prophylaxis failure Arch Gen Psychiat 1974 ; 30 : 229-33.CrossRefGoogle ScholarPubMed
Dunner, DLGershon, ESGoodwin, FK, Heritable factor in the severity of affective illness Biol Psychiat 1976 ; 11 : 31–42.Google Scholar
Goodwin, FKPost, RMDunner, DLGordon, EK. Cerebrospinal fluid amine metabolites in affective illness – The probenecid technique Am J Psychiatry 1973 ; 130 : 73-9.CrossRefGoogle ScholarPubMed
Joffe, RTKutcher, SMcDonald, C, Thyroid function and bipolar affective disorder Psychiat. Res. 1988 ; 25 : 117-21.CrossRefGoogle ScholarPubMed
Joyce, PR, The prognostic significance of thyroid function in mania J Psychiat Res 1991 ; 25 : 1–6.CrossRefGoogle ScholarPubMed
Kato, TTakahashi, SShioiri, TMurashita, JHamakawa, HInubushi, T. Reduction of brain phosphocreatine in bipolar II disorder detected by phosphorus-31 magnetic resonance spectroscopy J Affect Disord 1994 ; 31 : 125-33.CrossRefGoogle ScholarPubMed
Kramlinger, KGPost, RM. Addition of lithium carbonate to carbamazepine:hematological and thyroid effects AmJ Psychiat 1990 ; 147 : 615-20.Google ScholarPubMed
Leckman, JFGershon, ESNichols, ASMurphy, DL. Reduced MAOactivity in first-degree relatives of individuals with bipolar affective disorders Arch Gen Psychiat 1977 ; 34 : 601-6.CrossRefGoogle ScholarPubMed
Lombardi, GPanza, NBiondi, BDi Lorenzo, LLupoli, GMuscettola, G, et al. Effects of lithium treatment on hypothalamic-pituitary-thyroid axis: a longitudinal study J Endocrinol Invest 1993 ; 16 : 259-63.CrossRefGoogle ScholarPubMed
Rihmer, ZArató, M, ABO blood groups in manic-depressive patients J Affect Disord 1981 ; 3 : 1–7.CrossRefGoogle ScholarPubMed
Roy-Byrne, PPJoffe, RTUhde, TWPost, RM et al. Carbamazepine and thyroid function in affectively ill patients Arch Gen Psychiatry 1984 ; 41 : 1150-3.CrossRefGoogle ScholarPubMed
Schatzberg, AFSamson, JABloomingdale, KL, et al. Toward a biochemical classification of depressive disorders Arch Gen Psychiatry 1989 ; 46 : 260-8.CrossRefGoogle Scholar
Spaulding, SWBurrow, GNBermudez, FHimmelhoch, JM. The inhibitory effect of lithium on thyroid hormone release in both euthyroid and thyrotoxic patients J. Clin Endocrinol Metab 1972 ; 35 : 905-11.CrossRefGoogle ScholarPubMed
Spitzer, REndicott, JRobins, E. Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders 3rd ed. New York: New York State Department of Mental Hygiene, Biometrics Research; 1988. p. 52–68.Google Scholar
Wehr, TASack, DARosenthal, NACowdry, RW. Rapid cycling affective disorder: Contributing factors and treatment responses in 51 patients Am J Psychiatry 1988 ; 145 : 179-84.Google ScholarPubMed
Wenzel, KMeinhold, HRaffenberg, MAdlkofer, FSchleusener, H. Classification of hypothyroidism in evaluating patients after radioiodine therapy by serum cholesterol, T3-uptake, total T4, FT4-index, total T3, basal TSH, and TRH test Eur J Clin Invest 1974 ; 4 : 141-8.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.