A study of the TRH test in a family with psychiatric illness: A reflection on the TRH test as a state-trait marker

Biological PsychiatryPublished 1 May 1985

James C. Garbutt, John Hsiao, James P. Mayo, Jill Blacharsh

DOI10.1016/0006-3223(85)90029-0

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Citations31

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SJR score4.68

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TL;DR

Observations suggest that the TSH response in some cases is a state marker and in others a trait marker, and one method to test this is to study populations at risk for affective disorders, such as fam-

Abstract

The discovery that about 30% of depressed patients exhibit a blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) (Loosen and Prange 1982) has led to a number of strategies to investigate the significance of this marker. Currently, a major issue is whether the TRH test is state-dependent or is a trait marker. There is evidence to support both possibilities. Kirkegaard (1981) and Targum (1984) have noted that some TSH blunters change to nonblunters with recovery. Loosen et al. (1977) and Linkowski et al. (1981) have reported clear instances in which the blunted TSH response persists after remission. These observations suggest that the TSH response in some cases is a state marker and in others a trait marker. However, there is little information on whether or not a blunted TSH response is present prior to an affective episode. One method to test this is to study populations at risk for affective disorders, such as fam-

Keywords

PsychologyMedicineNeuroscience

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The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type, used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information.

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American Journal of PsychiatrySerum thyrotropin response to thyrotropin-releasing hormone in psychiatric patients: a review

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Present data allow some tentative conclusions that the fault usually reflects a defect in central regulation of the pituitary-thyroid axis, and in some patients the fault may be a trait marker, and it may represent a biological bridge between some depressed patients and some patients with other mental disorders.

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Investigation in patients with ED who were clinically cured after short-term antidepressant therapy found decreases present in anorexia nervosa and heroin addiction possibly were secondary to reduced caloric intake and administration of heroin, respectively.

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Findings suggest that persistent dysregulation may be a valuable prognostic marker reflecting partial treatment responsiveness in some patients which predisposes them to early relapse.

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74 Citations1983James C. Garbutt, Peter T. Loosen +2 more

The findings suggest that some patients with borderline personality disorder share a neuroendocrine abnormality with some affective disorder patients.

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The findings suggest that the differential TSH response to TRH in unipolar and bipolar patients may constitute biological markers of endocrine dysfunction in clinical subgroups of affective disorders.

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Evidence for a fault in hypothalamic pituitary regulation in some depressed patients but not in schizophrenic patients is provided, as no relationship was found between TSH response and severity of illness, clinical subtypes (unipolar/bipolar) and clinical remission.