Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese

Lang, Xiaoe; Hou, Xin; Shangguan, Fangfang; Zhang, Xiang Yang

doi:10.1016/j.jad.2019.11.004

Cited by 48 publications

(33 citation statements)

References 83 publications

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“…In clinical, we observed patients in the WG with higher HRDS-17 and HAMA scores. The results consisted with most studies, which reported that thyroid dysfunction indeed caused depressive and anxiety symptoms (4,(17)(18)(19)(20)(21). Therefore, this study has reconfirmed that hypothyroidism, even for a short duration, can cause abnormal mood swings and lead to increased risks of severe disorders such as depression and anxiety.…”

Section: Discussionsupporting

confidence: 78%

Abnormal Brain Glucose Metabolism in Papillary Thyroid Cancer Patients 4 Weeks After Withdrawal of Levothyroxine: A Cross-Sectional Study Using 18F-FDG PET/CT

Feng

Zou

et al. 2021

Front. Endocrinol.

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BackgroundThere is no doubt that thyroid dysfunction is associated with psychiatric disorders. A large amount of thyroid carcinoma patients displayed mood disorders after the withdrawal of levothyroxine (LT4). However, it is unclear whether the disorders are related to the transient withdrawal of LT4, and if yes, what the possible underlying mechanism is. This study aims to investigate the abnormal regional cerebral glucose metabolism (rCMRglu) in a group of papillary thyroid cancer (PTC) patients without LT4 for 4 weeks and prove the relationship between the abnormal rCMRglu with depression and anxiety.MethodsBrain 18F-FDG PET/CT data of 38 consecutive PTC patients with high/intermediate-risk from June 2016 to December 2017 have been analyzed. Of the 38 patients, 23 are in the LT4 withdrawal group (WG) and 15 in the LT4 replacement group (RG). These patients were also evaluated for depressive and anxiety symptoms within 24 h after the scans based on the Hamilton Depression Rating Scale (17 items, HRDS-17) and the Hamilton Anxiety Rating Scale (HAMA) respectively.ResultsThirty-eight patients (12 men, 26 women; age range, 25–69 years; mean age, 45.8 years) were selected in the study. Compared with the RG, patients in WG showed depression and anxiety with higher total scores of HRDS-17 and HAMA (14.7 ± 5.8 vs 3.8 ± 5.5, t = −5.74, p = 0.00; 9.3 ± 4.3 vs 2.7 ± 4.1, t = −4.74, p = 0.00, respectively). In the brain glucose metabolism analysis, the WG patients showed lower rCMRglu in Occipital_Mid_R and Postcentral_L. On the other hand, data illustrated significant rCMRglu increases in the Frontal_Sup_Orb_L. Compared with the healthy group (HG), the rCMRglu of the Postcentral_L and Precuneus_L showed hypoactivity, but the Hippocampus_R and the Temporal_Inf_L showed hyperactivity. This analysis yielded a significant correlation between abnormal rCMRglu with the free thyroxine level, the serum thyroid-stimulating hormone level, HRDS-17, and HAMA scores.ConclusionsThe findings showed that more PTC patients exhibited depression and anxiety after LT4 withdrawal for 4 weeks. More attention should be paid to these hypothyroid patients while they were in the hospital. Such a short-term LT4 withdrawal also likely induced abnormal rCMRglu. Our study attempts to explain the possible mechanism of mood disorders related to transient hypothyroidism.

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Section: Discussionsupporting

confidence: 78%

Abnormal Brain Glucose Metabolism in Papillary Thyroid Cancer Patients 4 Weeks After Withdrawal of Levothyroxine: A Cross-Sectional Study Using 18F-FDG PET/CT

Feng

Zou

et al. 2021

Front. Endocrinol.

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“…The relation between depression or anxiety disorders with TAI and hypothyroidism was recently described in a meta-analysis in the general population 8 and several other studies reported similar findings. According to these studies, patients with hypothyroidism, 22,23 TAI, 24 or even with elevated TPO-ab only 25 revealed an association to depression, anxiety, or bipolar disorders, respectively. We could confirm that this association between TAI and mood disorders is also observable in adolescents and young adults with T1D.…”

Section: Discussionmentioning

confidence: 96%

Are psychiatric disorders associated with thyroid hormone therapy in adolescents and young adults with type 1 diabetes?

Eckert

Galler

Papsch

et al. 2021

Journal of Diabetes

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Background: To evaluate the association between thyroid autoimmunity and psychiatric disorders (depression, anxiety, eating disorder, schizophrenia or attention-deficit/hyperactivity disorder) among adolescents and young adults with type 1 diabetes (11-25 years). Methods: We compared 9368 type 1 diabetes patients with thyroid autoimmunity (3789 of them treated with levothyroxine) with 62 438 type 1 diabetes patients without any thyroid disease from a multicentre diabetes patient follow-up registry (DPV) in terms of psychiatric disorders. Thyroid autoimmunity was defined as documented diagnosis of Hashimoto thyroiditis or positive antibodies against thyroid peroxidase or thyroglobulin. Multivariable logistic regression models were used to calculate odds ratios for the respective psychiatric disorders in type 1 diabetes patients with thyroid autoimmunity (overall and stratified by levothyroxine therapy) compared to type 1 diabetes patients without thyroid diseases (reference).

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“…Consistent with our hypothesis, our results demonstrate that MDD patients had lower TSH levels than HCs, in line with previous reports ( 33 ). Although the mechanisms for the association of depression and altered hypothalamic–pituitary–thyroid (HPT) axis activity have not been elucidated, many patients with depression present subtle alterations in thyroid function, as evidenced by the increasing prevalence of subclinical thyroid dysfunction among patients with depression, ranging from 12% to 60% ( 34 , 35 ). The alterations in thyroid function in MDD might be due to the blunted TSH response to thyrotropin-releasing hormone (TRH), and that the difference between 2300 h and 0800 h TSH responses to TRH (i.e., △△TSH) was reduced in 75% of depressed inpatients ( 36 , 37 ).…”

Section: Discussionmentioning

confidence: 99%

The Correlation Between Thyroid Function, Frontal Gray Matter, and Executive Function in Patients With Major Depressive Disorder

et al. 2021

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The present study was aimed to investigate the relationships between serum thyroid hormones (THs), frontal gray matter volume, and executive function in selected patients with major depressive disorder (MDD). One hundred and four MDD patients and seventy-five healthy controls (HCs) were subjected to thyroid-stimulating hormone (TSH), free Triiodothyronine (fT3), free Thyroxine (fT4), and executive function tests and underwent structural magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) analysis was performed to compare group differences in the gray matter for the frontal lobe. Furthermore, mediation analysis was used to investigate whether gray matter volumes of the frontal gyrus mediated the relationship between serum THs and executive function in MDD patients. MDD patients exhibited significant gray matter volume reduction in several brain regions, including the left rectus, right middle frontal cortex, and left middle frontal cortex. Serum TSH levels are positively associated with altered regional gray matter volume patterns within MFG and executive function. Importantly, gray matter in the right MFG was a significant mediator between serum TSH levels and executive function. These findings expand our understanding of how thyroid function affects brain structure changes and executive function in MDD patients.

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Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese

Cited by 48 publications

References 83 publications

Abnormal Brain Glucose Metabolism in Papillary Thyroid Cancer Patients 4 Weeks After Withdrawal of Levothyroxine: A Cross-Sectional Study Using 18F-FDG PET/CT

Abnormal Brain Glucose Metabolism in Papillary Thyroid Cancer Patients 4 Weeks After Withdrawal of Levothyroxine: A Cross-Sectional Study Using 18F-FDG PET/CT

Are psychiatric disorders associated with thyroid hormone therapy in adolescents and young adults with type 1 diabetes?

The Correlation Between Thyroid Function, Frontal Gray Matter, and Executive Function in Patients With Major Depressive Disorder

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