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基于医院样本的主要精神障碍中的甲状腺功能障碍

Thyroid dysfunction in major psychiatric disorders in a hospital based sample.

作者信息

Radhakrishnan Rajiv, Calvin Sam, Singh Jyotin Kshitiz, Thomas Binston, Srinivasan Krishnamachari

机构信息

Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.

出版信息

Indian J Med Res. 2013 Dec;138(6):888-93.

Abstract

BACKGROUND & OBJECTIVES: Abnormalities in thyroid hormonal status is common in major psychiatric disorders. Although the relevance of thyroid dysfunction to bipolar disorder is well-recognized, yet the association between thyroid dysfunction and schizophrenia-spectrum disorders is under-emphasized. The aim of this study was to examine and compare the rates of abnormal thyroid hormonal status in patients with schizophrenia-spectrum disorders and mood disorders in an inpatient tertiary care general hospital psychiatry unit.

METHODS

This was a retrospective hospital-based study on 468 inpatient samples. Data on serum thyroid stimulating hormone (TSH), T3 (triiodothyroxine), T4 (L-thyroxine), free unbound fractions of T3 and T4 (FT3 and FT4) were obtained from records of 343 patients, 18 patients were anti-TPO (anti thyroid peroxidase antibody) positive. The rates of abnormal thyroid hormonal status were compared using the chi square test.

RESULTS

Abnormal thyroid hormonal status in general, and presence of hypothyroidism and hyperthyroidism, in particular were seen in 29.3, 25.17 and 4.08 per cent patients with schizophrenia spectrum disorders, respectively. These were comparable to the rates in patients with mood disorders (23.24, 21.62 and 1.62%, respectively). Eleven of the 18 patients with antiTPO positivity had a schizophrenia-spectrum disorder. There were no gender differences.

INTERPRETATION & CONCLUSIONS: Thyroid dysfunction was present in patients with schizophrenia-spectrum disorder as well as mood disorders. Autoimmune thyroid disease was more commonly seen in patients with schizophrenia-spectrum disorders compared to mood disorders. The findings reiterate the relevance of screening patients with schizophrenia-spectrum disorders for abnormal thyroid hormonal status.

摘要

背景与目的

甲状腺激素状态异常在主要精神疾病中很常见。尽管甲状腺功能障碍与双相情感障碍的相关性已得到充分认识,但甲状腺功能障碍与精神分裂症谱系障碍之间的关联却未得到足够重视。本研究旨在调查并比较一家三级综合医院精神科住院部中精神分裂症谱系障碍患者和心境障碍患者甲状腺激素状态异常的发生率。

方法

这是一项基于医院的回顾性研究,纳入了468例住院患者样本。从343例患者的记录中获取血清促甲状腺激素(TSH)、T3(三碘甲状腺原氨酸)、T4(左旋甲状腺素)、游离T3和T4(FT3和FT4)的数据,18例患者抗甲状腺过氧化物酶抗体(anti-TPO)呈阳性。使用卡方检验比较甲状腺激素状态异常的发生率。

结果

总体而言,精神分裂症谱系障碍患者中甲状腺激素状态异常的发生率为29.3%,其中甲状腺功能减退和甲状腺功能亢进的发生率分别为25.17%和4.08%。这些发生率与心境障碍患者相当(分别为23.24%、21.62%和1.62%)。18例抗TPO阳性患者中有11例患有精神分裂症谱系障碍。不存在性别差异。

解读与结论

精神分裂症谱系障碍患者和心境障碍患者均存在甲状腺功能障碍。与心境障碍患者相比,自身免疫性甲状腺疾病在精神分裂症谱系障碍患者中更为常见。这些发现再次强调了对精神分裂症谱系障碍患者进行甲状腺激素状态异常筛查的重要性。

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