Alarcón R D, Shirriff J R, Kern E E
J Clin Psychiatry. 1985 Feb;46(2):61-3.
A 32-year-old woman with rapid cycling bipolar illness had numerous clinical problems throughout 19 affective episodes and six hospital admissions within 34 months. Persistent hyperthyroxinemia, always associated with manic episodes, led to a diagnostic work-up that ruled out a primary thyroid dysfunction and pointed to oral contraceptives, appetite suppressants, and psychiatric illness as likely causes of elevated T4 values. The contention that an underlying thyroid hypofunction is the basis of rapid cycling is questioned. The extent to which a bipolar disorder increases T4 levels and the role of euthyroid hyperthyroxinemia in the pathogenesis of rapid cycling are discussed.
一名32岁快速循环型双相情感障碍女性在34个月内经历了19次情感发作和6次住院，出现了诸多临床问题。持续性甲状腺素血症始终与躁狂发作相关，这促使进行了诊断性检查，排除了原发性甲状腺功能障碍，并指出口服避孕药、食欲抑制剂和精神疾病可能是T4值升高的原因。关于潜在甲状腺功能减退是快速循环基础的观点受到质疑。本文讨论了双相情感障碍使T4水平升高的程度以及甲状腺功能正常的甲状腺素血症在快速循环发病机制中的作用。
