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July 20, 1979

Thyroid Function Screening in Psychiatric Patients

Author Affiliations

From the Departments of Medicine (Dr Cohen) and Psychiatry (Dr Swigar), Yale-New Haven Hospital, and the West Haven Veterans Administration Hospital, West Haven, Conn (Dr Cohen).

JAMA. 1979;242(3):254-257. doi:10.1001/jama.1979.03300030026015

Abnormalities in levels of total thyroxine and thyroxine binding capacity were common in a group of 480 newly admitted psychiatric patients. The estimated free thyroxine (EFT4) level was elevated in 43 patients (9%). In 27 of these patients, the level of EFT4 became spontaneously normal, usually within a two-week period (acute "stress hyperthyroidism"). The level of EFT4 was decreased in 42 patients (9%). In 16 of these patients, the level became spontaneously normal; the etiology of this apparent acute hypothyroidism is unclear. The yield of new cases of primary hyperthyroidism and hypothyroidism was low, but a presumptive diagnosis of secondary hypothyroidism was made in eight patients. In addition, nine patients with known thyroid disease were taking inadequate or excessive replacement therapy. Thyroid function screening tests are of value in psychiatric patients.

(JAMA 242:254-257, 1979)