Thyroid Function Screening of Psychiatric Inpatient Admissions: A Worthwhile Procedure?

Bannister, P.; Mortimer, Ann; Shapiro, Lawrence E.; Simms, Andrew

doi:10.1177/014107688708000206

Cited by 20 publications

(8 citation statements)

References 11 publications

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“…All studies measured T4 concentrations and elevated levels were reported far more commonly than low ones, ranging from a ratio of nearly 2 to 1 (1,9,12, current study) to unity (3,6,10,11,19). While elevated T3 levels are typically observed (3,6,7,10,12), one study reported a four times greater frequency of low values than high ones (9). While elevated T3 levels are typically observed (3,6,7,10,12), one study reported a four times greater frequency of low values than high ones (9).…”

Section: Discussionmentioning

confidence: 59%

“…Multiple studies have shown that patients admitted for acute psychiatric care, both in the United States (1)(2)(3)(4)(5)(6)(7)(8) and worldwide (9)(10)(11)(12)(13)(14), have a prevalence of bonafide thyroid dysfunction that is similar to the general population (1,(7)(8)(9)(11)(12)(13), although few have been large scale, prospective investigations (1,3,7,9,12). Multiple studies have shown that patients admitted for acute psychiatric care, both in the United States (1)(2)(3)(4)(5)(6)(7)(8) and worldwide (9)(10)(11)(12)(13)(14), have a prevalence of bonafide thyroid dysfunction that is similar to the general population (1,(7)(8)(9)(11)(12)(13), although few have been large scale...…”

Section: Introductionmentioning

confidence: 99%

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Thyroid Evaluation of Hospitalized Psychiatric Patients: The Role of TSH Screening for Thyroid Dysfunction

Woolf¹,

Nichols²,

Porsteinsson³

et al. 1996

Thyroid

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The incidence and pattern of changes in thyroid function tests were studied in acutely hospitalized psychiatric patients and the cost effectiveness of a systematic screening program for thyroid dysfunction was estimated. Thyroid testing was performed on 1275 of 1424 (90%) admissions to the psychiatric wing of Strong Memorial Hospital between April 1, 1993 and March 30, 1994. Discharge samples were obtained in 232 patients who were hospitalized at least 2 days; 163 patients were admitted multiple times. Psychiatric diagnosis was coded using DSM-III-R criteria. TSH, T4, free T4, and T3 levels were measured within 48 h of admission. TSH values were most frequently abnormal (7.8%) and free T4 the least (1.3%). Admission and discharge thyroid tests were similar. Significant differences in the four parameters of thyroid function were present among the psychiatric groups. By analysis of variance every 1 microU/mL increase in TSH levels was associated with a 2.5% increase in length of stay (LOS) (95% confidence intervals: 0.21%, 4.75%), holding psychiatric diagnosis, age, and gender constant. For patients with elevated TSH levels, the average LOS was increased by 10.7 days (95% confidence intervals: 2.8, 18.7 days). It is concluded that patients hospitalized for psychiatric illness have an incidence of thyroid dysfunction at or slightly higher than the general population. However, patients with elevated TSH levels are hospitalized longer than those with normal or suppressed values.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Thyroid Evaluation of Hospitalized Psychiatric Patients: The Role of TSH Screening for Thyroid Dysfunction

Woolf¹,

Nichols²,

Porsteinsson³

et al. 1996

Thyroid

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“…Cohen and Swigar (1979) found a 0.4% rate of thyroid disease with screening TFTs and suggest such screening is useful. Bannister et al (1987) report a 0.6% rate and conclude that screening is not warranted. White and Barraclough (1988) report a 0.7% rate and do not recommend a general screening but do include affective disorders as an indication for TFTs.…”

Section: Discussionmentioning

confidence: 89%

Routine thyroid screening in psychiatric inpatients

Warner

Nader²,

Griffin

et al. 1993

Depression

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Routine thyroid screening tests are frequently ordered in psychiatric hospitals but there is no substantial evidence to justify this practice. Furthermore, there is little evidence to substantiate the belief that thyroid disease is more commonly associated with mood disorders than other psychiatric disorders. The few reports available do not take age and sex into account. The authors attempted to clarify both of these issues. A retrospective review of 3,188 psychiatric inpatient charts was conducted to determine the usefulness of routine thyroid junction tests (TFTs). While 25% of this population exhibited some abnormality in TFTs, the majority were judged insignificant. There was a 2.5% prevalence of thyroid disease and a 0.5% incidence of newly diagnosed thyroid disease based solely on screening TFTs. There was a significant relationship between mood disorders and thyroid disease with age and sex held constant. The prevalence of thyroid disease in psychiatric patients is consistent with the general population. Since there was a significant relationship between mood disorders and thyroid disease, if screening TFTs are performed, they may be most appropriate in this group. Whether routine TFTs should or should not be done on all psychiatric inpatients is not answered with this study. Depression 1:143–148 (1993). © 1993 Wiley‐Liss, Inc.

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“…11 In general, screening for thyroid dysfunction in the assessment of psychiatric patients remains controversial. 12,13 Bannister et al 14 noted that as many as 21.7% of routine thyroid test results of psychiatric patients were abnormal, whilst studies by White and Barraclough 15 found as few as 3% of thyroid test results abnormal. Research has also shown that up to 50% of psychiatric patients may have spuriously abnormal thyroid test results.…”

mentioning

confidence: 99%

The clinical utility and cost effectiveness of routine thyroid screening in adult psychiatric patients presenting at Stikland Hospital, Cape Town, South Africa

Lachman¹,

Cloete²,

Kidd³

et al. 2012

Afr. J. Psych

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Thyroid Function Screening of Psychiatric Inpatient Admissions: A Worthwhile Procedure?

Cited by 20 publications

References 11 publications

Thyroid Evaluation of Hospitalized Psychiatric Patients: The Role of TSH Screening for Thyroid Dysfunction

Thyroid Evaluation of Hospitalized Psychiatric Patients: The Role of TSH Screening for Thyroid Dysfunction

Routine thyroid screening in psychiatric inpatients

The clinical utility and cost effectiveness of routine thyroid screening in adult psychiatric patients presenting at Stikland Hospital, Cape Town, South Africa

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