A new study suggests that, rather than giving thyroid screening to all youth with severe psychiatric issues, it may be best to focus on those with a family history of thyroid disease or other thyroid symptoms, such as recent weight gain.
The thyroid gland is closely linked to brain function and plays a role in the regulation of many systems in the body including metabolism.
An overactive thyroid, or hyperthyroidism, can produce anxiety, weight loss, decreased appetite and poor concentration. Hypothyroidism (too little hormone production) can cause fatigue, weight gain, an increase in appetite, slower motor skills and concentration and may look like depression.
For the study, researchers from the University of Cincinnati (UC) and Cincinnati Children’s examined the prevalence of abnormal thyroid function in youth with severe mood and anxiety disorders.
“The American Academy of Child and Adolescent Psychiatry recommends that clinicians consider of hypothyroidism or hyperthyroidism when assessing anxious or depressed youth, given that some thyroid conditions produce anxiety or depressive symptoms,” says corresponding author Jeffrey Strawn, MD, associate professor in the Department of Psychiatry and Behavioral Neuroscience at the UC College of Medicine and director of UC’s Anxiety Disorders Research Program, who mentored Luft.
“However, until this study, we had limited evidence as to whether routine screening with a laboratory test was the best approach to screen for thyroid disease in kids with anxiety and depression.”
“These results suggest that screening, with a blood test, may be most helpful when the other predictors of thyroid disease are present.”
The study involved 1,319 patients under the age of 19 who had been hospitalized for psychiatric disorders at Cincinnati Children’s and who had received routine thyroid screening tests.
The team looked at the prevalence of thyroid disease in these patients as well as other factors that may have predicted abnormal thyroid hormone levels.
Their analysis found that the thyroid-stimulating hormone concentrations were abnormal in just over 6 percent of the youth hospitalized for psychiatric issues at Cincinnati Children’s.
“This is the largest study to examine the utility of thyroid function screening in psychiatrically hospitalized youth with severe mood and anxiety disorders, and though it relies on existing medical history data, it does help us better understand the predictors of abnormal thyroid function tests,” says collaborator, Laura Ramsey, PhD, assistant professor of pediatrics and clinical pharmacology.
Lead author Marissa Luft, a third-year medical student at UC, notes that from this study and other literature, they determined predictors of elevated thyroid-stimulating hormone levels.
“When considering thyroid assessment in youth with anxiety and mood disorders, targeted screening should focus on patients with a family history of thyroid disease, recent weight gain, treatment with specific medications, and in girls, any history of abnormal uterine bleeding,” says Luft.
“The prevalence of thyroid disorders is poorly understood in pediatric populations, particularly in the area of psychiatric disorders,” adds Luft, and believes the data can help inform more targeted approaches to screening, and will be of clinical interest to pediatricians, child and adolescent psychiatrists, and other mental health providers.
The findings are published in the Journal of Clinical Psychiatry.
Source: University of Cincinnati