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Objective: Depression is not adequately diagnosed in many cases. Therefore, the question arises as to whether markers exist for depression. We investigated whether the presence of thyroperoxidase antibodies (TPOAbs) during pregnancy can be regarded as a marker for depression in the ®rst year postpartum, particularly in relation to (overt or subclinical) thyroid dysfunction and other determinants of depression. Design: This work was a prospective observational study. Patients: A cohort of 310 unselected women (residing in the Kempen Region, southeastern Netherlands) were visited at 12 and 32 weeks gestation and at 4, 12, 20, 28 and 36 weeks postpartum. Methods: At each visit, TSH, free thyroxine and TPOAb testing was performed, determinants associated with depression were asked for, and depression was assessed (according to the Research Diagnostic Criteria). Multiple logistic regression was performed to determine independent risk factors (odds ratios, ORs) for depression in gestation and/or postpartum depression. Results: Data for 291 women were available for analysis; 41 women (14.1%) had TPOAbs at one or more time points, and 117 women (40.1%) had depression at one or more time points postpartum. The multiple logistic regression analysis showed that TPOAbs were independently associated with depression at 12 weeks gestation and at 4 and 12 weeks postpartum (OR, 95% con®dence interval: 2.4 (1.1±6.0), 3.8 (1.3±7.3) and 3.6 (1.2±7.1) respectively). After the exclusion of women who were depressed at 12 weeks gestation n 70, the presence of TPOAbs during early pregnancy was still found to be associated with the development of postpartum depression (OR, 95% con®dence interval: 2.8 (1.7±4.5); after exclusion of women who had had depression in earlier life n 51, TPOAb during early gestation was still associated with postpartum depression (OR, 95% con®dence interval: 2.9 (1.8±4.3). Conclusions: The presence of TPOAbs during gestation is associated with the occurrence of subsequent depression during the postpartum period and as such can be regarded as a marker for depression.

The objective of this study was to examine the relationship between autoimmune thyroid disease and depression in perimenopausal women. Thyroid function [TSH, free T4, and thyroid peroxidase antibodies (TPO-Ab)] and depression (using the Edinburgh Depression Scale) were assessed cross-sectionally together with other determinants of depression. The subjects were 583 randomly selected perimenopausal women (aged 47-54 yr) from a community cohort of 6846 women. The main outcome measures were the occurrence of thyroid dysfunction (abnormal free T4 and/or TSH or elevated levels of TPO-Ab) and the concomitant presence of depression according to the Edinburgh Depression Scale. Neither biochemical thyroid dysfunction nor menopausal status was related to depression. Apart from several psycho-social determinants (the occurrence of a major life event, a previous episode of depression, or financial problems), an elevated level of TPO-Ab (> or = 100 U/mL) was significantly associated with depression (odds ratio, 3.0, 95% confidence interval, 1.3-6.8). We conclude that women with elevated TPO-Ab levels are especially vulnerable to depression, whereas postmenopausal status does not increase the risk of depression.

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Children and adolescents; liaison and consultation psychiatry; disorders of reproduction; ... in the metropolitan area of the city of Milan. Italy were studied. Results showed that comorbidity for DSM Ill-R diagnoses was 92% with 31% and 70% of the subjects showing respectively Axis I & n psychiatric disorder. No statistically significant differences were found between HIV seropositive and HIV seronegative individuals with regard to psychiatric comorbidity. Further work should aim to clarify factors that are associated with psychiatric comorbidity and therapeutic compliance in individuals with a triple diagnosis of drug abuse, psychiatric disorder, and HIV infection.