Rao M L, Vartzopoulos D, Fels K
Department of Psychiatry, University of Bonn, FRG.
Pharmacopsychiatry. 1989 Mar;22(2):66-70. doi: 10.1055/s-2007-1014580.
We measured serum thyroid hormone levels, and pre- and post-TRH administration serum thyrotropin (TSH) in 46 psychiatric inpatients with major depression (n = 20), anxiety disorder (n = 9), and anxious depression (n = 17), and in 56 healthy subjects. Basal serum triiodothyronine was lower in female patients with major depression and anxious depression than in healthy women (P less than 0.05). Basal serum thyroxine was lower in female patients with anxious depression than in controls; all patients showed lower basal serum TSH than controls. In healthy subjects, basal triiodothyronine and thyroxine, basal TSH, and delta TSH (the increment of TSH after TRH administration) correlated, whereas no correlation was found between triiodothyronine and thyroxine in male patients with major depression, or between TSH and delta TSH in female patients with major depression or anxious depression. In female patients, 45% with major depression, 25% with anxiety disorder, and 35% with anxious depression showed a blunted TSH response. We also investigated pre- and post-dexamethasone administration cortisol levels in these patients. The sensitivity obtained by the combination of the results of the TRH and dexamethasone suppression tests for major depression, anxiety disorder, and anxious depression was 45%, 55%, and 65%, respectively.
我们检测了46例患有重度抑郁症（n = 20）、焦虑症（n = 9）和焦虑性抑郁症（n = 17）的精神科住院患者以及56名健康受试者的血清甲状腺激素水平，以及促甲状腺激素释放激素（TRH）给药前后的血清促甲状腺激素（TSH）。重度抑郁症和焦虑性抑郁症女性患者的基础血清三碘甲状腺原氨酸水平低于健康女性（P < 0.05）。焦虑性抑郁症女性患者的基础血清甲状腺素低于对照组；所有患者的基础血清TSH均低于对照组。在健康受试者中，基础三碘甲状腺原氨酸和甲状腺素、基础TSH以及TSH变化量（TRH给药后TSH的增量）之间存在相关性，而重度抑郁症男性患者的三碘甲状腺原氨酸和甲状腺素之间，或重度抑郁症或焦虑性抑郁症女性患者的TSH和TSH变化量之间均未发现相关性。在女性患者中，45%的重度抑郁症患者、25%的焦虑症患者和35%的焦虑性抑郁症患者表现出TSH反应迟钝。我们还研究了这些患者地塞米松给药前后的皮质醇水平。TRH和地塞米松抑制试验结果联合用于重度抑郁症、焦虑症和焦虑性抑郁症的敏感性分别为45%、55%和65%。
