Free T4 index and clinical outcome in patients with depression.
BACKGROUND
Many studies of patients with major depression have reported that a significant decrease in serum free T(4) index is associated with specific treatments; what has been unanswered is whether these observations are generalizable. This study evaluated baseline thyroid function and its relationship to rapidity of treatment response as measured by hospital length of stay (HLOS).


METHODS
Admission thyroid indices and HLOS data were harvested from the medical record of patients hospitalized for depression, both unipolar and bipolar. The relationship between admission thyroid indices and HLOS was evaluated using survival models.


RESULTS
Controlling for age and year of discharge, an inverse relationship between FT(4) index (FT(4)I) and HLOS was present in men, but not in women. The mean HLOS stratified by gender and median FT(4)I was 50% shorter in men with a relatively high FT(4)I in comparison to the other three groups.


CONCLUSIONS
This is a retrospective study limited by the absence of a structured diagnostic psychiatric interview and prospective controlled antidepressant evaluation.


CONCLUSIONS
These data would suggest that a relatively elevated FT(4) index in depressed men is associated with a faster antidepressant response time. Prospective study is encouraged to further clarify this potential thyroid/gender relationship and whether thyroid supplementation can accelerate the improvement in depression as measured by HLOS.
Abulseoud
Osama
O
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. oabulseoud@mednet.ucla.edu
Sane
Natasha
N
Cozzolino
Anthony
A
Kiriakos
Lindsay
L
Mehra
Vishal
V
Gitlin
Michael
M
Masseling
Susan
S
Whybrow
Peter
P
Altshuler
Lori L
LL
Mintz
Jim
J
Frye
Mark A
MA
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors; D013960:Thyroid Function Tests; D013974:Thyroxine / Q000097:blood*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D013974:Thyroxine