APPLICATION OF ENDOCRINOLOGICAL RESEARCH METHODS IN PSYCHIATRY

Abstract

The difficulties involved in any analysis of neuro-endocrine relationships are outlined. Whether disturbances arise primarily in the brain or in the endocrine system the series of repercussions usually results in a vicious circle which has to be broken at some point if therapy is to be tried. Hormone therapy of psychiatric cases has fallen into discredit because of its wide and indiscriminate use. Such treatment is only justified when the most exact and exhaustive tests of endocrine function have first been carried out. A number of such tests are discussed. Investigation of ¹³¹I metabolism of the thyroid makes it possible to detect borderline cases with only very slight (previously unsuspected) thyroid disturbances. In many such cases the correct treatment of the thyroid under- or over-function improves the mental condition. Insensitivity of the body tissues to thyroid hormone is assumed in cases where the radioactive tracer method shows an increased thyroid function while the B.M.R. is normal or decreased. The use of ACTH for clinical response tests for the adrenal cortex and for treatment of different mental cases is discussed, together with gonadal and pituitary anterior lobe function in its relation to mental disorder. Different psychopathological states can develop under identical endocrine conditions; different endocrine changes can be seen in cases which are to the psychiatrist 'identical entities'. The classical conception of psychiatric entities must be considered out of date if pathogenetic and causal analysis of mental disease is to be established.