Cognitive and affective status in mild hypothyroidism and interactions with l-thyroxine treatment

Bono, Giorgio; Fancellu, Roberto; Blandini, Fabio; Santoro, G; Mauri, M.

doi:10.1111/j.1600-0404.2004.00262.x

Cited by 92 publications

(70 citation statements)

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“…Cloyra Almeida, 1 Marco Antônio Brasil, 2 Antônio José Leal Costa, 3,4 Fabiola A A Reis, 5 Vaneska Reuters, 6 Patrícia Teixeira, 6 Márcia Ferreira, 6 Amanda M Marques, 7 Bianca A Melo, …”

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Subclinical hypothyroidism: psychiatric disorders and symptoms

Almeida

Brasil

Costa

et al. 2007

Rev. Bras. Psiquiatr.

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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.

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Subclinical hypothyroidism: psychiatric disorders and symptoms

Almeida

Brasil

Costa

et al. 2007

Rev. Bras. Psiquiatr.

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“…Studies about the neuropsychological and behavioral characteristics of patients with SH reported significant deficiencies in the abilities related to memory (12) and logical memory (13). A reduction was observed in the total memory coefficient, but it was not significant (13).…”

Section: Discussionmentioning

confidence: 93%

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confidence: 97%

“…Baldini et al (1997) and Bono et al (2004) found an association between the SH and neuropsychological alterations, as for the logical memory, attention, global cognitive functioning and some executive functions. The memory deficit reported by Bono et al (2004) was related only to age. Jorde et al (2005), in a population study, using a battery of tests to evaluate attention, visual and verbal memory, intelligence and executive functions, found no difference between patients with SH and euthyroid individuals.…”

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Are neuropsychological changes relevant in subclinical hypothyroidism?

Almeida

Vaisman

Costa

et al. 2007

Arq Bras Endocrinol Metab

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Introduction: Neuropsychological changes are still controversial in patients with subclinical hypothyroidism (SH). The objective of this study is to assess these changes. Method: Cross-sectional study comparing the results of the neurocognitive evaluation of 65 SH patients and 31 individuals without thyroid disease. Subclinical hypothyroidism was defined as at least two elevated serum TSH levels (> 4 µUI/ml) with normal serum free T 4 levels (0.9-1.8 ng/dl). The participants underwent the following neuropsychological assessment: Buschke's Selective Reminding Procedure, Rey-Osterrieth Complex Figure Test SEVERAL STUDIES HAVE reported a prevalence of overt hypothyroidism in the adult population of 1-2% and of subclinical hypothyroidism (SH) of 5-10%; women are more frequently affected than men are, at a ratio of 4:1. The prevalence of SH increases with age, reaching 15% among women older than 50 years, and decreases after the age of 80 years (1).

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“…Diversos trabalhos têm mostrado melhora do desempenho cognitivo com o tratamento, porém sem consenso definido na literatura (10,11,14,17,18). Contudo, caso seja evidenciada a potencialidade do tratamento nesses casos, a subsequente melhora da qualidade de vida deve ser analisada para se avaliar uma indicação formal do uso da levotiroxina em pacientes com HS.…”

Section: Discussionunclassified

Disfunções cognitivas em pacientes com hipotireoidismo subclínico

Fernandes¹,

Alvarenga

Silva³

et al. 2011

Arq Bras Endocrinol Metab

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OBJETIVO: Avaliar a presença de disfunções cognitivas em pacientes com hipotireoidismo subclínico (HS). SUJEITOS E MÉTODOS: Estudo seccional comparando os achados neuropsicológicos de 89 pacientes com HS e 178 indivíduos eutireoidianos. Para avaliação neuropsicológica, foram utilizados: Teste de Performance Contínua (CPT-II), Iowa Gambling Task, Teste de Stroop, Teste de Wisconsin (WCST), Teste da Figura Complexa de Rey-Osterreich, Teste de Fluência Verbal (categorias semântica e fonológica) e Teste de Aprendizagem Auditivo Verbal de Rey. RESULTADOS: Os pacientes mostraram pior desempenho na flexibilidade cognitiva (WCST) e na capacidade de manter atenção sustentada (erros por omissão no CPT-II). CONCLUSÕES: Esses déficits podem causar prejuízos na vida diária do paciente, constituindo possíveis indicações de tratamento.

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Cognitive and affective status in mild hypothyroidism and interactions with l-thyroxine treatment

Abstract: From the analysis of the results, treatment of asymptomatic MH would seem advisable in order to re-set hormonal levels and, particularly in older subjects, to protect the brain against the potential risk of cognitive and affective dysfunctions.

Cited by 92 publications

References 40 publications

Subclinical hypothyroidism: psychiatric disorders and symptoms

Subclinical hypothyroidism: psychiatric disorders and symptoms

Are neuropsychological changes relevant in subclinical hypothyroidism?

Disfunções cognitivas em pacientes com hipotireoidismo subclínico

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