Endocrine Abstracts

Objectives: To audit the endocrine referrals from a High Secure Hospital (HSH) to a department of endocrinology.

Methods: During the study, the HSH had approximately 400 beds, 75% male, 75% mental illness (mostly schizophrenia), 25% psychopathic personality disorders. The average length of stay in the HSH was 8 years, the majority of patients receive antipsychotic drugs (APD) and obesity and cigarette smoking is common.

Results: Over 10 years, 52 patients, median age 41 years, were seen. The endocrine conditions in order of frequency were:

Males (n=31): Thyrotoxic Graves’ disease (7), Hypothyroidism (6), Klinefelters syndrome (5), Hyponatremia and overdrinking (3), Miscellaneous (10).

Females (n=21): APD induced hyperprolactinemia, galactorrhoea, amenorrhoea (11), thyrotoxic Graves disease (6), Miscellaneous (4).

Conclusions: In this HSH, the commonest endocrine problem in males was thyrotoxic Graves disease, a condition relatively unusual in men. In several of these patients, marked deterioration in behaviour occurred when they were hyperthyroid.

In the female patients, galactorrhoea – amenorrhoea secondary to APD induced hyperprolactinemia was commonest. Treatment with dopamine agonists was usually successful with no deterioration of mental state.