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May 23, 1980

Thyroid Function Screening in Psychiatric Patients

Author Affiliations

Academisch Ziekenhuis der VU Amsterdam

JAMA. 1980;243(20):2028. doi:10.1001/jama.1980.03300460012005

To the Editor.—  The article by Cohen and Swigar (242:254, 1979) certainly adds to our knowledge on thyroid dysfunction in psychiatric patients, but a few points in this article and in the editorial comment in the same issue (242:275, 1979) warrant comment.First (and most important), the terms hyperthyroidism and hypothyroidism are used to include states of hyperthyroxinemia and hypothyroxinemia without clinical signs or sequelae. Notably, a diagnosis of secondary hypothyroidism, called "presumptive" in the abstract and once in the "Comment" only, was made in eight patients but substantiated in only one of these. The other cases, displaying "a relative lack of classic signs and symptoms of thyroid disease," include two patients with anorexia nervosa and two others taking phenytoin; these should not be considered (or treated) as hypothyroid. Actually, therefore, there appear to have been at least five and at most eight new cases of thyroid dysfunction, including one