Association of Subclinical Hypothyroidism With Anxiety Symptom in Young First-Episode and Drug-Naïve Patients With Major Depressive Disorder

Abstract

BackgroundsSubclinical hypothyroidism (SCH) was reported to be associated with depression; however, its role in coexisting anxiety symptom in young patients with major depressive disorder (MDD) remains unclear. The objective of this study was to explore the relationship between SCH and anxiety symptom in young first-episode and drug-naïve (FEDN) MDD patients.MethodsA total of 520 outpatients diagnosed as FEDN MDD with SCH were recruited in this study. Their socio-demographic, clinical data and thyroid function parameters were collected. The Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Rating Scale (HAMD) were employed to measure the severity of anxiety symptom and depressive symptom, respectively. Based on the HAMA scores, patients who scored ≥ 25 were defined as anxious major depressive disorder (A-MDD) while others as non-anxious major depressive disorder (NA-MDD).ResultsThe prevalence rate of A-MDD was 15.8% in young FEDN MDD patients with comorbid SCH. Moreover, serum thyroid stimulating hormone (TSH) levels were significantly higher in patients with A-MDD compared with those with NA-MDD (p < 0.001). Multivariate binary logistic regression analysis indicated that A-MDD was associated with serum TSH levels with an odds ratio (OR) of 1.602. Serum TSH level of 6.17 mIU/L was the critical value to distinguish A-MDD and NA-MDD, with sensitivity of 0.805 and specificity of 0.539. There were no statistically significant differences between NA-MDD and A-MDD patients in terms of socio-demographic variables, serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidases antibody (TPOAb) and anti-thyroglobulin (TgAb) levels.ConclusionsA-MDD patients presented higher serum TSH level. It is suggested that serum TSH level may be a potential biomarker for predicting moderate and severe anxiety symptoms in young FEDN MDD patients with SCH.

Prevalence and Factors Associated with Subclinical Hypothyroidism in Major Depressive Disorder Patients with Dyslipidemia

“…14 The pathophysiological mechanism of MDD is also closely related to the somatic endocrine metabolic state, and the thyroid gland is one of the glands responsible for metabolism in the body, which secretes thyroid hormones that can affect the body's energy metabolism, cardiovascular function, cerebral neurotransmission, and other physiological processes. 15 It has been shown that the prevalence of MDD is higher in patients with subclinical hypothyroidism, 16,17 and several studies on subjects of different ethnic and cultural backgrounds have shown that the incidence of depression increases immediately after hypothyroidism or thyroidectomy. 18,19 Thyroid function is not only closely related to MDD but also affects lipid metabolism in the body.…”

Integrative effects of transcutaneous auricular vagus nerve stimulation on esophageal motility and pharyngeal symptoms via vagal mechanisms in patients with laryngopharyngeal reflux disease

“…Reduced parasympathetic activity and sympathetic imbalance are implicated in conditions like refractory gastroesophageal reflux disease (rGERD) and functional outlet obstructive constipation (FOOC; Liu et al, 2020 ). Strategies aimed at enhancing parasympathetic activity might offer efficacy in addressing these disorders ( Liu et al, 2020 ; Yang et al, 2022 ). Meanwhile, our latest basic study reported that tVNS significantly improved the constipation-predominant irritable bowel syndrome symptoms ( Liu et al, 2024 ).…”

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Association between thyroid function and psychotic symptoms in adolescents with major depressive disorder: A large sample sized cross-sectional study in China

“…Hormones in the hypothalamus-pituitary-thyroid (HPT) axis may influence the course of mental disease [ [14] , [15] , [16] ]. Patients with thyroid function disorder exhibit a high prevalence of depression [ 17 , 18 ]. Numerous large sample sized studies with participants from different cultural and ethnic backgrounds have demonstrated correlations between thyroid function, including hyper- and hypoactivity of thyroid function, and depression [ [19] , [20] , [21] ].…”