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Abstract
Serum free thyroxine (FT4), total thyroxine (TT4), and Brief Psychiatric Rating Scale (BPRS) measurements were obtained following
hospital admission and at 2-week intervals during hospitalization in 80 male psychiatric
inpatients with a variety of major psychotic and affective disorders. A strong correlation
between the range values for BPRS sum and for FT4 (p < 0.005) and TT4 (p < 0.001) levels indicated that change in overall symptom severity was linked to change in thyroxine
levels during clinical recovery. We found the relationship not to be a simple one,
but to require definition of criteria for three patient subgroups for each hormone,
taking Into account the Initial absolute thyroxine level, as well as the direction
and magnitude of hormonal change during recovery. The hormonally defined “good recovery”
subgroup included patients with high initial thyroxine levels that then fell substantially,
patients with low initial thyroxine levels that then rose substantially, and patients
with initial thyroxine levels in the middle range that subsequently changed substantially.
The hormonally defined “poor recovery” subgroup included those patients not meeting
these criteria. The degree of clinical improvement in the hormonally defined good
recovery group was significantly greater by almost twofold than the poor recovery
group both for FT4 (p < 0.04) and TT4 (p < 0.02). These findings suggest that a “normalizing” principle underlies the relationship between
clinical recovery and thyroxine levels and that both FT4 and TT4 levels within the normal range appear to have clinical significance in either reflecting
or contributing to the course of a variety of psychiatric disorders and possibly having
a role in pathogenesis.
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Article info
Publication history
Received in revised form:
September 16,
1987
Received:
March 9,
1987
Footnotes
☆Supported in part by Veterans Administration Research Funds and National Institute of Mental Health Research Scientist Award MH-00346 to J.W.M.
Identification
Copyright
© 1989 Published by Elsevier Inc.
