Letters to the Editor The 24th Annual Meeting of the Canadian Psychiatric Association as seen by a clinical endocrinologist Dear Sir: hand the clinical effects of TRH administraPsychiatrists may find interesting some tion on depression are still under discussion observations of an endocrinological col- with controversial results. Are kinetic league which were stimulated by the 1974 studies with labeled T4 and T3 during TRH C.P.A. meeting. administration in depression not yet availaPolysymptomatic diencephalic syn- . ble? dromes associated almost always with some A similar situation exists concerning cormental disorder offer an endless possibility of paper production with psychosomatic tisol studies in depression: it is not likely that the assessment of free cortisol in addicontent. Collecting static data and looking tenaciously for new syndromes could lead tion to total cortisol levels and the assessto obscurantism and loss of the already ment of transcortin will provide a definite small s.olid diagnostic base - for example, answer to why cortisol suppressants have anorexia nervosa of 'well nourished' and no therapeutic effect. Perhaps again a kinet'undernourished' type, with hypothy- ic.study here involving cortisol and ACTH, roidism and diabetes mellitus, with Tur- Will be a reasonable way to obtain an ner's syndrome and ovarian tumour, with explanation. The potential of biochemical investigavagi~al bleeding and periods of hypertions in psycho-geriatrics (in which there phagia and so on. The response of the clinic psychiatrist to such papers will be negative, are many 'model conditions' for neurothat of the endocrinologist probably dis- endocrinological studies) has obviously not yet been clearly realized. tracted. It also seems that each project involving It is obvious that the dynamic approach is the clinical testing of a new psychotropic the only one possible for good clinical drug should include biochemical dynamic neuroendo~rinological investigation, preinvestigation: assessment of thyroid horferably usmg long-term retrospective stumones, growth hormone, prolactin, dies with laborious biochemical dynamic tests under particularly favourable condi- gonadotropins before and during the tions. For instance, a paper giving data of p~ychotropic drug administration, suppresapomorphine-induced growth hormone sec- sion and stimulation tests, glucose loading, retion is much more useful than many pap- CP 154, apomorphine and so on. These ers describing anorexia nervosa in the con- should be required and should be paid text of bizarre, inconstant diencephalic for by the manufacturer. The pure syndromes; and an attempt to find signific- psychopharmacological approach presently ant somatic characteristics in schizop- III vogue does not seem to be sufficient for hrenics is much less promising than to progress in this field. Of particular interest were the papers follow somatic characteristics from childabout the assessment of monoamines in the hood till the onset of schizophrenia. brain and the use of radioactive FluroIt is surprising that the role and function o! thyrotropin releasing hormone in depres- DOPA turnover in intact humans. No other endocrinologist seemed to be sion has not yet been clarified: on the one pr~sent at the meeting, which brings to ~and it is almost certain that the thyroid axis mind the famous sentence of Freud who in IS som~how involved in the etiology of 1923 declared endocrinology to be the disdepression (cAMP and monoamine studies effects of lithium on depression and on the cipline closest to psychiatry. thyroid, potentiation of tricyclic antidepresS. Hontela, M.D. sants by triiodothyronine, etc.): on the other Montreal 95