January 1982

Using the Protirelin Test to Distinguish Mania From Schizophrenia

Author Affiliations

From Fair Oaks Hospital, Summit, NJ (Drs Extein, Pottash, and Gold); the Clinical Psychobiology Branch, National Institute of Mental Health, Bethesda, Md (Drs Extein and Cowdry); the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn (Drs Pottash and Gold); and Psychiatric Diagnostic Laboratories of America, Summit, NJ (Drs Pottash and Gold).

Arch Gen Psychiatry. 1982;39(1):77-81. doi:10.1001/archpsyc.1982.04290010053010

• To explore the possible utility of the protirelin test in differentiating manic and schizophrenic patients, we gave a test dose of protirelin to 30 consecutive euthyroid inpatients who met Research Diagnostic Criteria for mania, 30 who met criteria for schizophrenia, undifferentiated subtype, and 20 normal volunteer controls. The mean maximal thyroid-stimulating hormone (TSH) response (▵TSH) to protirelin in the manic patients was lower than in the schizophrenic patients and in the controls. This mean difference was not attributable to differences in age, sex, baseline thyroid functioning, cortisol levels, or medication, but there was a considerable overlap of values in the patient groups. However, with a ▵TSH less than or equal to 7.0 IμU/ml to identify manic patients in the overall group, the sensitivity of the protirelin test was 60% and the specificity was 84%