Avaliação clínica e de sintomas psiquiátricos no hipotireoidismo subclínico

Teixeira, Patrícia de Fátima dos Santos; Reuters, Vaneska Spinelli; Almeida, Cloyra; Ferreira, Márcia Martins; Wagman, Márcia Branco; Reis, Fabíola Alves Aarão; Costa, Antônio José Leal

doi:10.1590/s0104-42302006000400020

Cited by 10 publications

(5 citation statements)

References 22 publications

(33 reference statements)

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“…showed no improvement in depressive symptoms after one year of treatment (according to the BDI) in a group of older individuals (mean age grea ter than 60 years old) from the overall population, without complaints, and with lower serum levels of TSH than our patients (28). Our sample was different from that, since it included patients from a hospital environment, with higher TSH, and more initial complaints of depression, as previously demonstrated (31,32).…”

Section: Discussionmentioning

confidence: 97%

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Reuters

Almeida

Teixeira

et al. 2012

Arq Bras Endocrinol Metab

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Objectives:To evaluate the impact of subclinical hypothyroidism (sHT) treatment on health--related quality of life (QoL), psychiatric symptoms, clinical score, and muscle function. Materials and methods: In this randomized double-blind study, patients were assigned either to treatment (n = 35) or placebo (n = 36). Clinical and psychiatric symptoms were assessed by the Zulewski, Hamilton and Beck scales. QoL was assessed by the SF-36 questionnaire. Assessments of quadriceps (QS) and inspiratory muscle (IS) strength were performed by a chair dynamometer and a manuvacuometer. Results: Treatment improved IS (+11.5 ± 17.2; p = 0.041), as did QoL domains "Pain" and "Role Physical" (+19.7 ± 15.2, 0.039 and +22.1 ± 47.5, p = 0.054; respectively). Clinical and psychiatric symptoms showed similar responses to both interventions. Conclusions: sHT treatment improved IS and physical aspects of QoL, despite no impact in other muscle parameters. Clinical score, psychiatric symptoms, and SF-36 domains, based on mental dimensions of QoL may be more susceptible to "placebo effect" in patients with sHT.Arq Bras Endocrinol Metab. 2012;56(2):128-36 Keywords Anxiety; depression; quality of life; levothyroxine RESUMO Objetivos: Avaliar o impacto do tratamento do hipotireoidismo subclínico (sHT) na qualidade de vida relacionada à saúde (QoL), aos sintomas psiquiátricos, ao escore clínico e à função muscular. Materiais e métodos: Em um ensaio randomizado duplo-cego, pacientes foram randomizados para tratamento (n = 35) ou uso de placebo (n = 36). Sintomas clínicos e psiquiá-tricos foram acessados por meio das escalas de Zulewski, Hamilton e Beck. A QoL foi avaliada pelo questionário SF-36. Medidas da força de quadríceps (QS) e inspiratória (IS) foram obtidas por um dinamômetro de cadeira e um manovacuômetro. Resultados: O tratamento melhorou a IS (+11,5 ± 17,2; p = 0,041), assim como os domínios "Dor" e "Aspectos Físicos" da QoL (+19,7 ± 15,2, 0,039 e +22,1 ± 47,5, p = 0,054, respectivamente). Sintomas clínicos e psiquiátricos demonstraram respostas similares a ambas as formas de intervenção. Conclusões: Tratamento do sHT melhorou IS e aspectos físicos da QoL, apesar de não ter impacto em outros parâmetros musculares. Escore clínico, sintomas psiquiátricos e domínios do SF-36 que focam em dimensões mentais podem ser mais suscetíveis ao "efeito placebo" em pacientes com sHT.

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Section: Discussionmentioning

confidence: 97%

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Reuters

Almeida

Teixeira

et al. 2012

Arq Bras Endocrinol Metab

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“…They are involved in myocardial contractility, central nervous system activity, nerve growth factor (NGF) synthesis, muscle contraction processes, intestinal motility, and tooth development and eruption (17) . Clinical complaints are more frequent in patients with subclinical hypothyroidism than in those with euthyroidism, and less frequent than in those with overt hypothyroidism (18) . The delay in tooth development (in terms of tooth formation stages, not eruption) is less pronounced than bone age delay, and the therapeutic response is also less intense.…”

Section: Discussionmentioning

confidence: 94%

Atraso na erupção dental em adolescente com hipotireoidismo

Vitalle

Weiler

Niskier

et al. 2012

Rev. paul. pediatr.

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OBJETIVO: Relatar o caso de adolescente que procurou serviço odontológico de um ambulatório de medicina do adolescente por apresentar atraso de erupção dentária. A atuação multiprofissional permitiu chegar ao diagnóstico de hipotireoidismo. DESCRIÇÃO DO CASO: Paciente de 16 anos e 4 meses cuja queixa inicial foi atraso na erupção dentária. Na avaliação odontológica, chamava atenção o importante atraso na erupção dentária, o que poderia estar relacionado a alguma moléstia orgânica. Desta forma, solicitou-se a intervenção da equipe médica, que, no acompanhamento, constatou se tratar de hipotireoidismo. COMENTÁRIOS: Chama-se a atenção o fato de que adolescentes prezam a aceitação pelos seus pares e as questões estéticas e, muitas vezes, a procura por um serviço de saúde envolve queixas que podem parecer triviais. Porém, o olhar atento não deixará que problemas orgânicos mais graves passem despercebidos. Salienta-se ainda a importância da atuação da equipe multiprofissional.

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“…It has long been debated whether this condition is a normal variation of thyroid function and if the L-T4 replacement has any beneficial effect. There are some population-based studies in adults which have investigated the effect of SH on quality of life, signs and symptoms and cognitive function; however, all the reported results were controversial ( 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ). The effects of SH and its treatment on cognitive development is of particular interest in children, since it is well known that hypothyroidism in young children has effects on brain development.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Six-Month L-Thyroxine Treatment on Cognitive Functions and Event-Related Brain Potentials in Children with Subclinical Hypothyroidism

Sangün¹,

Demirci²,

Dündar³

et al. 2015

Jcrpe

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Objective: The aim of this study was to investigate the cognitive status of children with subclinical hypothyroidism (SH) before and after L-thyroxine (L-T4) treatment using event-related potentials (ERPs) and neuropsychological tests.Methods:This prospective study was conducted on a series of 20 children with mild SH (free T4 normal and thyroid-stimulating hormone level within 5-10 µIU/L) who underwent clinical and cognitive assessment before L-T4 treatment and 6 months afterwards. The recordings of ERPs were done at the time of diagnosis and after 6 months of euthyroid state. Neuropsychiatric tests for attention, perception, close and remote memory were performed on all patients and on the control group which consisted of 20 healthy children of normal intelligence.Results:While pretreatment verbal memory (VM) and verbal recall (VR) scores of the SH group were significantly lower than those of the control group (p=0.004 and 0.012, respectively), no significant differences between the post-treatment and control groups were found in these scores after 6 months of L-T4 treatment. Post-treatment VM and VR scores were significantly higher than the pretreatment scores in the SH group (p=0.008 and p=0.0001). There were no significant differences between the pre-and post-treatment values of electrophysiological evaluation in N1, P2, P3 latencies or P3 amplitude (p>0.05), although there was a significant decrease in N2 latency in the post-treatment group (p=0.03).Conclusion:SH affects cognition in children and L-T4 replacement therapy leads to normalization of cognitive functions. Neuropsychological tests can be used as complementary measures in the evaluation of children with SH. Determining the association between ERPs and SH would contribute to the comprehensive evaluation of these children.

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Avaliação clínica e de sintomas psiquiátricos no hipotireoidismo subclínico

Abstract: The study showed that SH was associated with clinical findings and with psychiatric symptoms. Clinical trials are required to evaluate possible improvement with levotiroxine.

Cited by 10 publications

References 22 publications

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Atraso na erupção dental em adolescente com hipotireoidismo

The Effects of Six-Month L-Thyroxine Treatment on Cognitive Functions and Event-Related Brain Potentials in Children with Subclinical Hypothyroidism

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