title: Rapid cycling bipolar affective disorder. I. Association with grade I hypothyroidism.
abstract: Thirty patients with rapid cycling bipolar affective disorder were studied prospectively to assess presence and severity of thyroid hypofunction. Seven (23%) were classified as having grade I hypothyroidism, while 8 (27%) had grade II and 3 (10%) had grade III abnormalities. This prevalence of grade I hypothyroidism is significantly greater than that reported in studies of unselected bipolar patients during long-term treatment with lithium carbonate, although only 63% of this sample of rapid cycling patients was taking lithium carbonate or carbamazepine. The association of rapid cycling with grade I hypothyroidism cannot be accounted for by lithium carbonate use or by the preponderance of women among rapid cycling patients. These findings (1) indicate that hypothyroidism during bipolar illness is a risk factor for the development of rapid cycling, and (2) leads to the hypothesis that a relative central thyroid hormone deficit occurring in bipolar patients predisposes to a rapid cycling course.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia 19104.
authors.forename: M S
authors.initials: MS
authors.lastname: Bauer
authors.forename: P C
authors.initials: PC
authors.lastname: Whybrow
authors.forename: A
authors.initials: A
authors.lastname: Winokur
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D002220:Carbamazepine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000175:diagnosis*; D008094:Lithium / Q000627:therapeutic use; D016651:Lithium Carbonate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone
chemical_list: D016651:Lithium Carbonate; D002220:Carbamazepine; D013973:Thyrotropin-Releasing Hormone; D013972:Thyrotropin; D008094:Lithium