The impact of the hypothalamic-pituitary-thyroid axis hormone levels on suicide risk in patients with schizophrenia

Aim . To assess the impact of thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) concentrations in the blood serum of patients with schizophrenia with suicide risk. Materials and methods . A total of 120 patients with schizophrenia (75 women and 45 men) were examined. Suicide risk was assessed using the Beck Hopelessness Scale (BHS). Serum levels of FT3, FT4 and TSH in patients with schizophrenia were determined using enzyme immunoassay kits. Multiple linear regression analysis and single-factor analysis of variance (ANOVA) were used to identify the relationships between the studied indicators. Results . Among 120 patients with schizophrenia, 11 patients (9.2%) had elevated serum TSH values (> 4.0 mME/L), 108 (90%) had decreased FT3 levels, (< 4.0 pmol/L), 42 (35%) had decreased FT4 levels (< 10.3 pmol/L). The study revealed statistically significant differences in the level of hopelessness between the groups of patients with normal and elevated TSH (F (1.118) = 5.160, p = 0.025), as well as with normal and decreased FT3 (F (1.118) = 4.568, p = 0.035). Conclusion . It was found that TSH and FT3 concentrations in blood serum significantly affect the level of hopelessness assessed using the Beck scale in patients with schizophrenia. The results of this study confirm the need for regular dynamic monitoring of hormone levels of the hypothalamic-pituitary-thyroid axis in patients with schizophrenia in order to maintain its normal functioning, as well as prevent adverse effects in the form of suicide attempts and suicide.