TRH test and DST in schizoaffective mania, mania, and schizophrenia.

The thyrotropin-releasing hormone (TRH) test and the Dexamethasone Suppression Test (DST) were given to 10 patients who met Research Diagnostic Criteria (RDC) for schizoaffective disorder, manic type, 9 who met the criteria for mania, and 27 who met the criteria for schizophrenia. A blunted thyrotropin (TSH) response to TRH was observed in 3 of the 10 schizoaffective manics, 4 of the 9 manics, and 3 of the 27 schizophrenics. Nonsuppression on the DST was observed in 5 of the 10 schizoaffective manics, 2 of the 9 manics, and 2 of 22 schizophrenics. The schizoaffective manic and the manic patients had similar rates of TSH blunting and DST nonsuppression, and these were significantly higher than the rates in the schizophrenic patients. This difference was not attributable to baseline TSH and cortisol levels or to neuroleptic treatment. It is suggested that patients with RDC schizoaffective mania and mania have more disturbance in the hypothalamic-pituitary adrenal and thyroid axes than patients with schizophrenia.