Elevated thyroid indices in children and adolescents with obsessive-compulsive disorder: effects of clomipramine treatment.

OBJECTIVE To examine the basal thyroid function in pediatric Obsessive Compulsive Disorder (OCD) versus controls, and to explore the relation between baseline thyroid measures and response to clomipramine treatment, and the effects of treatment on thyroid hormones. METHODS Sixteen children and adolescents with DSM-III-R OCE and 13 control children and adolescents without psychiatric illness were compared on basal measures of thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4). For the OCD subjects, samples were compared pre- and post- 4 weeks of treatment with clomipramine. Response of OCD symptoms was measured by the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). RESULTS OCD subjects demonstrated subtle but significant elevations of TSH, T3, and T4 pre-treatment compared to controls. Clomipramine treatment was associated with significant decreases in TSH and T3 concentrations. Pre-treatment TSH and T4 concentrations correlated with reductions in CY-BOCS following 8 weeks of clomipramine. CONCLUSION Elevated thyroid function at baseline may be a biomarker of OCD improvement, and may reflect aspects of the underlying pathophysiology of OCD.