Sokolov S T, Kutcher S P, Joffe R T
Mood Disorders Program, University of Toronto, Canada.
J Am Acad Child Adolesc Psychiatry. 1994 May;33(4):469-75. doi: 10.1097/00004583-199405000-00004.
Abnormalities of the thyroid axis are documented in adult mood disorders. The most consistent findings have been observed in major depressive disorder with elevations of thyroxine (T4) or free-T4 (fT4) within the euthyroid range that decrease with treatment. The literature on adolescents is limited, and it is unknown whether similar findings might be present in this population.
First admissions to a university hospital adolescent psychiatry unit were reviewed. Fourteen depressed and 13 manic patients satisfied inclusion and exclusion criteria. None had a history of thyroid illness or medical illness or were taking medications known to affect thyroid function. Basal serum thyrotropin, T4, fT4, triiodothyronine (T3), reverse-T3, free thyroxine index (FTI), and T3 resin uptake levels were compared with those of a group of adolescent normal controls.
T4 (but not fT4) was elevated in depressed and manic patients compared with controls (p < .05). In manic patients, T3 was decreased and reverse-T3 was increased (p < .05). There were no significant differences in relation to age, sex, or suicidality.
We observed significant differences in basal thyroid hormone levels in depressed and manic adolescents. Our results suggest the presence of abnormalities of thyroid function in adolescent mood disorders similar to those described in mood-disordered adults.
甲状腺轴异常在成人情绪障碍中已有记载。最一致的发现是在重度抑郁症患者中观察到甲状腺素（T4）或游离T4（fT4）在甲状腺功能正常范围内升高，且随着治疗而降低。关于青少年的文献有限，尚不清楚该人群中是否也会出现类似的发现。
回顾了大学医院青少年精神科首次收治的患者。14名抑郁患者和13名躁狂患者符合纳入和排除标准。他们均无甲状腺疾病或其他内科疾病史，也未服用已知会影响甲状腺功能的药物。将基础血清促甲状腺激素、T4、fT4、三碘甲状腺原氨酸（T3）、反T3、游离甲状腺素指数（FTI）和T3树脂摄取水平与一组青少年正常对照进行比较。
与对照组相比，抑郁和躁狂患者的T4（而非fT4）升高（p < 0.05）。在躁狂患者中，T3降低，反T3升高（p < 0.05）。在年龄、性别或自杀倾向方面无显著差异。
我们观察到抑郁和躁狂青少年的基础甲状腺激素水平存在显著差异。我们的结果表明，青少年情绪障碍中存在甲状腺功能异常，与情绪障碍成人中描述的情况相似。
