Subclinical hypothyroidism: psychiatric disorders and symptoms

Abstract

A b s t r a c t Objective: To evaluate the prevalence of psychiatric disorders and symptoms in patients with subclinical hypothyroidism. Method: Ninety-four outpatients with at least two elevated serum thyrotrophin levels (> 4 μU/ml) and normal FT 4 , and 43 euthyroid outpatients, both groups from HUCFF-UFRJ, were evaluated. Psychiatric diagnosis was based on the Structured Clinical Interview Diagnostic for the DSM-IV axis I (SCID-I/DSM-IV), the psychopathological symptoms on Hamilton anxiety and depression scales, and the Beck Inventory. Results: Our data showed an increased prevalence of psychiatric disorders in the subclinical hypothyroidism patients when compared to the euthyroid group (45.7% vs 25.6%; p = 0.025), mood disorders being the most frequent. The prevalence of depressive symptoms based on Beck's Scale among subclinical hypothyroidism patients was about 2.3 times higher than among euthyroid ones (45.6% vs 20.9%, p = 0.006). Anxiety symptoms were also more frequent among subclinical hypothyroidism patients (87.0% vs 60.5%, p < 0.001), mainly clinical anxiety (44.6% vs 23.3%; p = 0.001). Conclusion: Our results showed a significant association of subclinical hypothyroidism with psychiatric disorders and an increased frequency of subsyndromic depression and anxiety symptoms in subclinical hypothyroidism in relation to the euthyroid group.Descriptors: Hypothyroidism; Anxiety disorders; Mood disorders; Symptoms; Prevalence Resumo Objetivo: Avaliar a prevalência de sintomas e alterações psiquiátricas em pacientes com hipotireoidismo subclínico. Método: Foram estudados 94 pacientes ambulatoriais com pelo menos duas dosagens plasmáticas elevadas de tireotropina (> 4 μU/ml) e com T 4 livre normal e, 43 eutireoidianos, ambos os grupos do HUCFF-UFRJ. Para diagnóstico psiquiátrico foi utilizada a entrevista clínica estruturada do eixo I (SCID-I/DSM-IV) e, para sintomas psicopatológicos, as escalas de ansiedade e depressão de Hamilton (HAM-A e HAM-D) e inventário de Beck. Resultados: Encontramos uma prevalência aumentada de transtornos psiquiátricos no hipotireoidismo subclínico em comparação ao grupo eutireoidiano (45,7% vs 25,6%; p = 0,025), sendo o transtorno do humor o de maior freqüência. Sintomas de depressão no grupo com hipotireoidismo subclínico foram cerca de 2,3 vezes mais freqüentes que entre os eutireoidianos (45,6% vs 20,9%; p = 0,006) quando o instrumento utilizado foi a escala de Beck. Da mesma forma, sintomas de ansiedade também foram mais freqüentes no hipotireoidismo subclínico (87,0% vs 60,5%; p < 0,001), principalmente ansiedade clínica (44,6% vs 23,3%; p = 0,001). Conclusão: Os resultados indicaram uma associação do hipotireoidismo subclínico com os transtornos psiquiátricos, além de uma freqüência aumentada de sintomas de depressão e ansiedade subsindrômicos em relação ao grupo eutireoidiano.

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

“…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).…”

Disfunções cognitivas em pacientes com hipotireoidismo subclínico

“…Poucos são os estudos que avaliaram déficits cognitivos nesses pacientes, apesar do provável comprometimento de funções cerebrais superiores, sugerido pela frequente presença de sintomas neuropsiquiátricos, como, por exemplo, sintomas depressivos (8,9). Reforçando essa ideia, uma das plausíveis indicações de tratamento do HS é a presença concomitante de sintomas psiquiátricos (2,8,9).…”

“…Reforçando essa ideia, uma das plausíveis indicações de tratamento do HS é a presença concomitante de sintomas psiquiátricos (2,8,9).…”

Hypothyroidism: diagnosis and screening, genetic influences, and treatment options

“…In these cases a diagnosis of subclinical thyroid disease, mild thyroid failure, or subclinical hypothyroidism is given. Other possible symptoms include those related to cognitive functions, such as memory deficit, despondency, as well as symptoms of depression and anxiety (2).…”

“…Depending on the degree of impairment of TSH receptor (TSHr) function, patients display a variety of symptoms in addition to those previously mentioned (i.e. memory deficit, despondency, symptoms of depression and anxiety) (2).…”