Routine thyroid screening in psychiatric inpatients

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.