BIOL PSYCHlATRY 1986;21:565-579
did not have data on all of the subjects in the original study. The reduced fT3 is still consistent with the possibility that a “relative central hypothyroidism” (Linnoila et al. 1983) exists in depressed patients, resulting from decreased availability of active T3 through increased conversion of T4 to inactive reverse T3, even though this reduction might follow from loss of weight. Further studies are needed to determine whether the changes we reported provide useful clinical data with respect to diagnosis or response to antidepressant therapy. This interaction between weight loss and reduced tT3 also points to the need for careful examination of alterations in other neuroendocrine and neurotransmitter measures, particularly when values observed in depressed patients fall within the ranges found in normal individuals. George
Carol Fairchild A. John Rush
Departments of Psychiatry and Pathology University of Texas Health Science Center Dallas Dallas, TX 75235
References Linnoila M, Cowdry R, Bror-Axe1 L, Makinen T, Rubinow D (1983): CSF triiodothyronine (rTj) levels in patients with affective disorders. Biol Psychiatry 18: 1489-1492.
To the Editor: The paper on psychogenic polydipsia by Vieweg et al. in your December 1985 issue reminded me that Grunebaum and I had published a paper on the saltlosing syndrome of chronic schizophrenia in the Archives of Neurology
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Paul J. Orsulak
Polydipsia, although it occurred in our series, was neither regular nor marked. On the other hand, if
Figure 1. Relationship between free triiodothyronine (ff,) and weight loss rated on the Hamilton Depression Rating Scale: 0, no weight loss; 1, probable weight loss; 2, definite weight loss.
Orsulak PJ, Crowley G, Schlesser MA, Giles D, Fairchild C, Rush AJ (1985): Free triidothyronine (TX) and thyroxine (T4) in a group of unipolar depressed patients and normal subjects. Biol Psychiurry 20:1047-1054.
catatonia with marked water retention was seen occasionally, it made me wonder why patients with this syndrome, if it was indeed, as some claimed, due to voluntary withdrawal from the real world, felt constrained to take so much water with them. Mark D. Altschule
Harvard Medical School Countway Library of Medicine Boston, MA 02115