Depression and Hypothyroidism in a Population-Based Study of Iranian Women

Abstract

Background. Recent biochemical and physiological investigations have focused on the fundament of mood disorders in thyroid dysfunction. The present study aimed to address depressive disorder in a sample of Iranian hypothyroid women compared to euthyroid individuals.Methods. Thirty consecutive hypothyroid female patients aged 25 to 40 years who referred to the Endocrinology and Metabolism Clinic at Rasoul-e-Akram Hospital in Tehran within a four-month period in 2015 were assessed. Thirty healthy euthyroid subjects matched for sex, age, and educational level were selected as the control. For assessment of depression status, Depression Anxiety Stress Scale-21 (DASS-21) was employed.Results. The study showed higher mean depression score in hypothyroid patients when compared to euthyroid ones (13.8 ± 9.5 versus 5.8 ± 5.2, p = 0.010). No significant association was revealed between mean depression score and patients' education level (p = 0.627), age (p = 0.967), occupation status (p = 0.211), and marital status (p = 0.556).Conclusion. Hypothyroid women are predisposed to depressive symptoms independent of their baseline demographic and socioeconomic characteristics.

Factors Related to Breast Cancer Screening in Women in the Northern Part of Iran: A Cross-Sectional Study

“…Women with underlying diseases, such as diabetes, high blood pressure, and thyroiditis, had a rate of performing breast self-examinations that were 29% lower than women who had no underlying diseases. Different studies have shown that the prevalence of depression and mood disorders was high in women with diabetes, high blood pressure, hypothyroidism, and hyperthyroidism [26], [27], [28], [29]. Given that depression and mood disorders are considered barriers to self-care behaviours [30], the results of this study were noticeable, and the rate of performing breast self-examination for women with a history of underlying diseases was lower than the rate for healthy women.…”

Depression of the elderly revealing a primary hypothyroidism

“…] These manifestations may be severe, [18,19] and may exceptionally reveal the disease. [10,18] Depression remains rare, complicating only 4% of overt hypothyroidism [20] and is often characterized by its severity and its resistance to antidepressant therapy. [21,22] Indeed, the multicenter European study of resistant depression (GSRD Study) performed on 1410 patients, showed that 13% of subjects with a major depressive syndrome had underlying hypothyroidism.…”

“…[21] This depression appears to be more common in elderly subjects, particularly women, and it has been shown that hypothyroid women are significantly predisposed to the development of depressive syndrome regardless of their basic demographic and socio-economic characteristics. [20] The particular frequency of depression during hypothyroidism suggests common mechanisms to the point that several authors present the hypothesis of "brain hypothyroidism" to explain the pathogenesis of depression during this endocrinopathy. [13] This theory is based on the effects of deprivation in thyroid hormones on brain tissue, and on the direct effects of thyroid pathology, especially autoimmune thyroiditis.…”

“…[23] In overt forms, the simple hormone replacement therapy of hypothyroidism significantly improves and even eliminates mood disorders, including depression, in these subjects. [15,[17][18][19][20] In the subclinical forms of hypothyroidism, and even in the absence of consensus, the presence of neuropsychiatric manifestations is an indication for hormone replacement therapy. [24] In this context, the interesting study of Talaei A et al allowed to define a "TSH cut off point" associated with depression in patients treated for hypothyroidism.…”

Prevalence of depression among hypothyroid patients attending the primary healthcare and endocrine clinics of King Fahad Hospital of the University (KFHU)

“…[20] An Indian case–control study done in Mumbai 2017 studied the relationship between depression and hypothyroidism and concluded that inflammatory cytokines are associated with depression that can be relieved by treating autoimmune hypothyroidism, so they recommended that all patients with depression should be screened for hypothyroidism. [21] Two cross-sectional studies conducted in India (2016–2017) to estimate the prevalence of depression among hypothyroid patients on 100 and 144 patients showed that about 60% and 12.5% of hypothyroid patients had depression, respectively.…”