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Prevalence of Thyroid Disorders in Psychogeriatric Inpatients A Possible Relationship of Hypothyroidism with Neurotic Depression but not with Dementia
Author(s) -
Tappy L.,
Randin J. P.,
Schwed P.,
Wertheimer J.,
LemarchandBéraud Th.
Publication year - 1987
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1987.tb01399.x
Subject(s) - medicine , depression (economics) , dementia , etiology , thyroid , neuroticism , thyroid function , thyroid function tests , basal (medicine) , population , pediatrics , psychiatry , thyroid disease , endocrinology , disease , personality , psychology , social psychology , environmental health , insulin , economics , macroeconomics
Thyroid disorders are known to manifest occasionally as isolated psychiatric disorders. In order to determine whether thyroid dysfunctions could play a significant role in the pathogenesis of psychiatric disorders in the elderly, the prevalence of thyroid disorders was compared in a group of psychogeriatric patients and in a group of nonpsychiatric elderly patients. Thyroid function screening was performed in 157 patients consecutively admitted to a psychogeriatric unit, and the prevalence of hypothyroidism was determined in the different groups of psychiatric disorders (senile and multi‐infarct dementia, organic brain syndrome of other etiologies, psychotic depression, neurotic depression, chronic delusional state, acute confusional state, and personality disorder). Thyroid function screening was performed similarly in 104 unselected elderly patients admitted to the medico‐surgical admission unit of the University hospital to assess the prevalence of hypothyroidism in a general, nonpsychiatric, elderly population. Eight patients were diagnosed as hypothyroid based on an elevated basal thyrotropin (TSH) and on thyrotropin‐releasing hormone (TRH) test in the total number of patients, two in the nonpsychiatric and six in the psychiatric group. Three had clinical hypothyroidism, with decreased total and free T 4 and T 3 plasma levels in addition to increased basal TSH, five had biochemical hypothyroidism, with normal T 4 and T 3 levels and an excess TSH response to oral TRH. The prevalence of hypothyroidism in the two groups did not differ significantly (1.9% in the nonpsychiatric versus 3.8% in the psychiatric group). The prevalence of hypothyroidism in a subgroup of 88 patients with senile and multi‐infarct dementia was 2.3%. It was not statistically different from that of the general nonpsychiatric geriatric population. The prevalence of hypothyroidism in a subgroup of 27 patients with neurotic depression was 14.8%. It was significantly higher than the prevalence found both in the overall psychogeriatric group and in the general geriatric group. It is concluded that hypothyroidism is not involved in cognitive disorders, but may play a role in the pathogenesis of some depressive disorders in the elderly.