Figure 5.

Depression and endocrine disorders. Cushing's syndrome and hypothyroidism are accompanied by a high rate of psychiatric morbidity. The raised concentration of thyrotrophin releasing hormone in cerebrospinal fluid in patients with depression is noted in a previous study. Secondary hypothyroidism is characterized by decreased blood level thyroid-stimulating hormone, which is concomitant with an increased risk of depressive episodes. It is found that 40% of patients with hypothyroidism suffer from clinical depression. Hyperthyroidism patients have a high risk of depression by 28% compared with normal individuals, whereas it occurs in 50% of all cases of patients with hypothyroidism. Blood and cerebrospinal levels of T4 are relatively increased during the depression. T4, thyroxin; TSH, thyroid stimulating hormone.