<b>The prevalence of affective disorder and in particular of a rapid cycling of bipolar disorder in patients with abnormal thyroid function tests</b>

Oomen, H. A. P. C.; Schipperijn, A. J. M.; Drexhage, Hemmo A.

doi:10.1046/j.1365-2265.1996.d01-1558.x

Cited by 94 publications

(61 citation statements)

References 25 publications

(31 reference statements)

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“…In humans, alterations of thyroid function are associated with psychiatric disturbances, especially depressed mood, reversible with substitution therapy. 2,68 TH treatment is also beneficial in bipolar disorders resistant to other forms of treatment. 69,70 Concerning cognitive functioning, there was no difference among the experimental groups in the long-term object recognition memory.…”

Section: Discussionmentioning

confidence: 99%

Modulation of adult hippocampal neurogenesis by thyroid hormones: implications in depressive-like behavior

et al. 2006

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Hormonal imbalances are involved in many of the age-related pathologies, as neurodegenerative and psychiatric diseases. Specifically, thyroid state alterations in the adult are related to psychological changes and mood disorders as depression. The dentate gyrus of the hippocampal formation undergoes neurogenesis in adult mammals including humans. Recent evidence suggests that depressive disorders and their treatment are tightly related to the number of newly born neurons in the dentate gyrus. We have studied the effect of thyroid hormones (TH) on hippocampal neurogenesis in adult rats in vivo. A short period of adultonset hypothyroidism impaired normal neurogenesis in the subgranular zone of the dentate gyrus with a 30% reduction in the number of proliferating cells. Hypothyroidism also reduced the number of newborn neuroblasts and immature neurons (doublecortin (DCX) immunopositive cells) which had a severely hypoplastic dendritic arborization. To correlate these changes with hippocampal function, we subjected the rats to the forced swimming and novel object recognition tests. Hypothyroid rats showed normal memory in object recognition, but displayed abnormal behavior in the forced swimming test, indicating a depressive-like disorder. Chronic treatment of hypothyroid rats with TH not only normalized the abnormal behavior but also restored the number of proliferative and DCX-positive cells, and induced growth of their dendritic trees. Therefore, hypothyroidism induced a reversible depressive-like disorder, which correlated to changes in neurogenesis. Our results indicate that TH are essential for adult hippocampal neurogenesis and suggest that mood disorders related to adult-onset hypothyroidism in humans could be due, in part, to impaired neurogenesis.

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Section: Discussionmentioning

confidence: 99%

Modulation of adult hippocampal neurogenesis by thyroid hormones: implications in depressive-like behavior

et al. 2006

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“…So far, an association between thyroid autoimmunity and depression has been described only with a univariate model and a cross-sectional design in which higher prevalence rates of depression and/or more severe complaints of depression were reported in TPOAb+ women (9,10,16,17), while others could not demonstrate such an association (22). However, depression is thought to have a multifactorial origin, which implies that when investigating the effect of thyroid disease on depression other independent factors should also be taken into account (5).…”

Section: Discussionmentioning

confidence: 99%

Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum

Kuijpens

Vader²,

Drexhage³

et al. 2001

European Journal of Endocrinology

143

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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.

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“…The significance of elevated FT 4 I levels can be further assessed by measuring serum T 3 and sensitive TSH on the same serum sample. Currently the alternative approach using 'TSH first' screening has not found favour in psychiatric settings, and in recent reports transient TSH elevation is more common than TSH suppression (17,18).…”

Section: European Journal Of Endocrinology (2000) 142mentioning

confidence: 99%

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

Brownlie

Rae²,

Walshe³

et al. 2000

European Journal of Endocrinology

117

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Objective: To report a series of newly diagnosed thyrotoxic patients with concurrent acute psychosis, and to assess the association between the two disorders. Design: Retrospective study of thyrotoxic patients with associated psychosis ('thyrotoxic psychosis'; TP) requiring inpatient psychiatric care. New Zealand thyrotoxicosis annual incidence figures and first psychiatric admission rates for affective psychosis were utilised to statistically assess the co-occurrence of thyrotoxicosis and affective psychosis. Patients and Methods: During the 20-year study period, 18 inpatients (16 women and 2 men), mean age 54 years, with TP were identified. No patient had a past history of thyrotoxicosis, but four had required psychiatric inpatient care many years earlier. Thyrotoxicosis was documented by radioimmunoassay of thyroid hormone levels, and thyroid scintiscan. Psychiatric manifestations were classified using ICD9 criteria. Results: Thyroid hormone levels were markedly elevated in more than half of our TP patients. All younger patients had Graves' disease, and most older patients toxic nodular goitre. All patients were treated with antithyroid drugs, and all but one subsequently received 131 I therapy. Two patients were not mentally ill when thyrotoxicosis was diagnosed, but suffered major mood swings when thyroid hormone levels were falling. There was no specific psychiatric clinical picture but affective psychoses were commonest -seven depression, seven mania. The other diagnoses were two schizophreniform, one paranoid, and one delirium. Initially, neuroleptic medication was used in all but one patient, and during long-term follow-up (median 11 years) more than half our series had remained well with no further psychiatric problems. Statistical analysis was restricted to thyrotoxic patients with first psychiatric hospital admission for affective psychosis. During the 20-year period, there were nine thyrotoxic patients (95% confidence interval 4.5-17.1) with concurrent affective psychosis requiring first admission, and the calculated expected number was only 0.36. These findings indicate a clear association well above chance co-occurrence. Conclusion: TP is not a specific clinical picture, but affective psychoses are commonest. Statistical analysis of thyrotoxic patients with concurrent affective psychoses showed an incidence well above chance co-occurrence. It appears that thyrotoxicosis may be a precipitant of acute affective psychosis.

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The prevalence of affective disorder and in particular of a rapid cycling of bipolar disorder in patients with abnormal thyroid function tests

Cited by 94 publications

References 25 publications

Modulation of adult hippocampal neurogenesis by thyroid hormones: implications in depressive-like behavior

Modulation of adult hippocampal neurogenesis by thyroid hormones: implications in depressive-like behavior

Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

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