Page 41 - JCBP-1-2

Journal of Clinical and
Basic Psychosomatics Thyroid hormones and psychiatric disorders

Receptors for thyroid hormones are localized in routine clinical settings [1,25] . The most common psychiatric
the limbic structure, implying their involvement in conditions associated with suicide include affective
mood regulation . Hypothyroidism is associated with disorders, addictions, personality disorders, and psychotic
[8]
clinically relevant mood and cognition deterioration . disorders. These conditions vary with respect to gender,
[9]
Augmentation with thyroid hormone has demonstrated age, and geographic location [26,27] . Considering the absence
therapeutic efficacy in treating resistant depression [10,11] . In of an efficient algorithm for predicting suicide in clinical
addition, the thyroid hormone status has been recognized practice, mostly attributable to the etiologic heterogeneity,
as a predictor of therapeutic response in major depressive gathering information on clinical, psychological,
disorder and bipolar affective disorder . sociological, and biological factors can help in identifying
[12]
Thyroid-stimulating hormone (TSH) secretion is patients at high risk and providing valuable insights for
[28]
known to change, especially during nighttime, under the their treatment .
influence of various conditions [13,14] . Existing literature Different neurobiological factors related to suicide
presents somewhat contradictory findings regarding the are currently under investigation [1,28] . Neuroendocrine
relationship between thyroid hormone levels in psychiatric hormones play an important role in the regulation of
patients. Most psychiatric patients exhibit disturbances in emotions in both healthy individuals and those with
thyroid hormone and TSH levels, even in the absence of psychiatric conditions . The neurotransmitter systems,
[26]
thyroid disease . The underlying reasons for these hormone including the serotonergic system, may have a connection
[4]
level changes in psychiatric disorders have yet to fully to the regulation of the hypothalamic-pituitary-adrenal
unravel [15,16] . There are indications that this phenomenon (HPA) axis and hypothalamic-pituitary-thyroid (HPT)
may be linked to alterations in TSH secretion, induced axis in individuals at risk of suicide [29,30] . Dysregulation
by abnormalities in key neurotransmitters (serotonin, of the HPT axis has been observed in various psychiatric
noradrenaline, and dopamine) [17,18] . conditions, including those associated with suicidality [31,32] .
Changes in thyroid hormone levels are known to Genetic polymorphism in the serotonergic system,
influence a diverse range of health conditions. For HPA axis, noradrenergic system, and polyamines may
example, even when within normal limits, low TSH levels predispose patients to suicidal behavior [6,33-35] . Chronic
have been linked to poorer control of chronic diseases stress and hypercortisolism can result in hyperstimulation
such as arterial hypertension, Type 2 diabetes mellitus, of the HPA axis, leading to alterations in the 5-HT
and cardiovascular diseases . Thyroid dysfunction is pathway. Consequently, the observed 5-HT abnormalities
[19]
common in patients within the schizophrenia spectra but in suicidal patients may be secondary, stemming from the
remains understudied . It is also essential to consider hyperactivity of the HPT axis . The existing literature
[20]
[33]
the effect of psychiatric medications on thyroid hormone presents contradictory findings concerning the relationship
status [6,21] . Routine monitoring of thyroid hormone levels between suicidality and the HPT axis [31,36] . Changes in
is not typically conducted in patients taking antipsychotic the HPT axis activity have been documented in patients
medications unless they exhibit symptoms of thyroid diagnosed with depression and schizophrenia, both in
disease [22,23] . conjunction with the previous suicide attempt [31,37-41] .
Certain studies have indicated thyroid dysfunction in The literature indicates a connection between disorders
patients with schizophrenia who do not exhibit clinically in the HPT axis and certain personality traits, such as
relevant thyroid-related symptoms [24,25] . There appears to panic, as well as a link between agitation, suicidality, and
be a disorder in the regulation of the thyroid hormone a decreased response in the production of TSH . People
[42]
levels in these patients. Furthermore, the homeostasis of with a history of suicide attempts and higher levels of
thyroid hormones plays a role in maintaining the network aggressiveness may exhibit a decreased T3/T4 ratio [43,44] .
of neurotransmitters in the brain, but further research is
necessary to understand this issue to a greater extent [21,24] . The first hypothesis of the present research posited
that thyroid hormone abnormalities are involved in the
Suicide is an important psychopathological
phenomenon, posing one of the most challenging clinical etiopathogenic mechanism of psychiatric disorders. The
second hypothesis proposed that these thyroid hormone
dilemmas for psychiatrists in their daily practice. Central abnormalities serve as predictors of suicidality.
to the understanding of suicide are questions regarding its
nature, etiology, and even its definition. These inquiries The primary objective of this research was to establish
guide the psychiatric interventions and the identification differences in the concentration of the total T3, T4, and
of predictors of suicidality, which are essential for the TSH among patients diagnosed with common psychiatric
timely detection and prevention of fatal outcomes in disorders. The secondary objective was to determine whether

Volume 1 Issue 2 (2023) 2 https://doi.org/10.36922/jcbp.1130