Functional Status of Hypothalamic–Pituitary–Thyroid and Hypothalamic–Pituitary–Adrenal Axes in Hospitalized Schizophrenics in Shanghai

Abstract

Objective: Neuroendocrine dysfunction is related to the pathogenesis of mental disorders, but conclusions from clinical research lack consistency. We aimed to investigate the neuroendocrinal pathophysiology and its correlation with clinical symptoms in patients with schizophrenia. Methods:The present cross-sectional study included 486 inpatients with schizophrenia admitted at a psychiatric hospital in Shanghai within one year, and 154 healthy controls (HC) matched on age and gender. The serum hemoconcentrations of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), adrenocorticotrophic hormone (ACTH), and cortisol (COR) were measured via electrochemical luminescence immunoassay. Pathophysiological conversions of neuroendocrine were then associated with gender, age, age at onset, antipsychotic treatment using hierarchical multiple linear regression.Results: When compared to HC, the schizophrenia group showed elevated ACTH and COR levels and decreased TT3 and TT4 levels (p's < 0.05). First-episode patients showed lower TSH and higher FT3 and FT4 (p's < 0.05) compared to recurrent patients. Female patients showed higher TSH and lower TT3, FT3, and ACTH levels (p's < 0.05) compared to males. We observed the area under the curve (AUC) of the predictive model to distinguish between schizophrenia and HC to be 0.737 among total samples and between first-episode and recurrent schizophrenia to be 0.890 among subgroups.Conclusions: Decreased TT3 and TT4 and elevated ACTH and COR levels appear to be associated with schizophrenia symptoms. The chronic recurrent trait of schizophrenia Frontiers in Psychiatry | www.frontiersin.org

Associations of C-Reactive Protein, Free Triiodothyronine, Thyroid Stimulating Hormone and Creatinine Levels with Agitation in Patients with Schizophrenia: A Comparative Cross-Sectional Study

“… 48 Some studies have described thyroid dysfunction in patients with schizophrenia spectrum disorders. 49 , 50 Moreover, there is evidence that patients with first-episode schizophrenia have higher FT3 and FT4 levels than healthy controls, 51 , 52 as well as higher FT3 and FT4 levels and a lower TSH level than patients with recurrence of schizophrenia. 52 However, some investigators have reported that patients with schizophrenia using antipsychotic medications had a lower FT4 level than healthy controls, 26 , 53 and that a lower FT4 level was associated with the use of antipsychotics in regression analyses.…”

“…49 , 50 Moreover, there is evidence that patients with first-episode schizophrenia have higher FT3 and FT4 levels than healthy controls, 51 , 52 as well as higher FT3 and FT4 levels and a lower TSH level than patients with recurrence of schizophrenia. 52 However, some investigators have reported that patients with schizophrenia using antipsychotic medications had a lower FT4 level than healthy controls, 26 , 53 and that a lower FT4 level was associated with the use of antipsychotics in regression analyses. 53 Notably, our study detected a significantly higher FT4 level and a significantly lower TSH level only in patients with schizophrenia and agitation and not in those without agitation.…”

Functional Status of Hypothalamic-pituitary-thyroid axis and Prolactin level in Patients with First-episode of Bipolar Disorder in Mania State

“…In order to discuss the relationship between the differences of sex in thyroid disease and hyperprolactinemia, we needed to know whether they both signi cantly correlated to sex [16] [31]. We thus recruited patients aged 16 to 40 with sexual characteristics set as a confounding factor.…”

The Relationship of Functional Status of Cortisol, Testosterone, and Parameters of Metabolic Syndrome in Male Schizophrenics

“…The endocrine changes of adrenal and sex steroids may improve cognition in schizophrenia [ 31 , 32 ]. However, testosterone secretion in males goes through a process of natural decline with the recession of testicular function.…”

“…For considering the potential interaction effect between the cortisol and testosterone levels, regression analyses showed that the correlation coefficients involving these two predictors were the highest among the regression models. However, the relationship between the C/T ratio and schizophrenia is complicated, relating to the course of disease, age, and duration of antipsychotic medication [ 31 ]. It is also possible that the dosage of antipsychotic drugs, which was not recorded in the present study, has an impact.…”