Subclinical hypothyroidism and symptoms of depression: Evidence from the National Health and Nutrition Examination Surveys (NHANES)

Airaksinen, Jaakko; Komulainen, Kaisla; García-Velázquez, Regina; Määttänen, Ilmari; Gluschkoff, Kia; Savelieva, Kateryna; Jokela, Markus

doi:10.1016/j.comppsych.2021.152253

Cited by 20 publications

(17 citation statements)

References 21 publications

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“…In patients with subclinical hypo-thyroidism, mental symptoms are more likely to be presented with nonspecifi c manifestations such as fatigue, cognitive impairment, and altered mood [32,33]. Some recent data even did not observe associated increased risk for depression in such patients with subclinical hypothyroidism [8,34]. Among older adults, subclinical hypothyroidism is more probably to be associated with higher risk of dementia and a larger cognitive decline [35].…”

Section: Hypothyroidism and Depressionmentioning

confidence: 99%

“…Psychiatric manifestations of hypothyroidism are often presented by depression, anxiety, lack of as-sertiveness, and psychosis [5,6]. Subclinical hypothyroidism may also be associated with depression in younger adults (under the age of 60 years), but data are controversial and this observation requires further research and investigation [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Pathophysiology and Management Possibilities of Thyroid-Associated Depression

Ivanov

Bakalov

Bocheva

2022

Acta Medica Bulgarica

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Thyroid hormones and the hypothalamic-pituitary-thyroid (HPA) axis are responsible for multiple metabolic processes and psychological well-being. Hypothyroidism can induce mood changes, depressive symptoms and even major depressive disorder. This review is focused on the pathophysiology and mechanisms through which the low level of thyroid hormones may affect the brain function, causing the characteristic symptoms of depression. Key pathways of hypothyroid-associated depressive states include: morphological changes in some brain areas (mainly in the hippocampus – a reduction in its volume); a significant reduction of the cerebral blood flow (incl. hippocampus), and lowered levels of neurotrophic factors (e. g. BDNF – brain-derived neurotrophic factor), which are regulated by the thyroid hormones. An adequate and timely thyroid hormone replacement and treatment with conventional antidepressants often can reverse the psychological symptoms.

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Section: Hypothyroidism and Depressionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathophysiology and Management Possibilities of Thyroid-Associated Depression

Ivanov

Bakalov

Bocheva

2022

Acta Medica Bulgarica

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“…We believed that this phenomenon is not only related to the increased psychological burden of DTC patients due to RAI therapy itself, but also to the fact that patients stop thyroid hormone supplementation before RAI therapy, and patients in the status of hypothyroidism might lead to psychological symptoms. However, some studies suggested that there is no signi cant relationship between hypothyroidism and depression or anxiety (52,53). Therefore, anxiety and depression in these patients are more likely to be related to fear of RAI therapy.…”

Section: Discussionmentioning

confidence: 97%

Anxiety and depression status prior to radioactive iodine therapy among differentiated thyroid cancer patients during the COVID‑19 epidemic

Qiao

Gao

Tong

et al. 2022

Preprint

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Objection: The psychological health of thyroid cancer patients cannot be ignored, however, few studies have been conducted on the psychological status and influencing factors of thyroid cancer patients before radioactive iodine (RAI) therapy. The aim of the study was to investigate the incidence and risk factors of anxiety and depression in thyroid cancer patients prior to RAI therapy. Methods: Clinical data were collected among differentiated thyroid cancer patients (DTCs) preparing for RAI therapy. Anxiety and depression were measured before RAI therapy by using the Generalized Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). We used chi-square test and logistic regression analysis to find independent risk factors for anxiety and depression.Results: A total of 112 patients with thyroid cancer were included. Of these, 72.32 % (n=81) were female, with an mean age of 41.50 years. Anxiety and depression were reported by 46 (41.08%) and 38 (33.93%) patients, respectively. Based on chi-square test and univariate logistic regression analysis, being female and having ever-experienced RAI therapy were independent risk factors for anxiety and depression among DTCs prior to RAI therapy. On multivariate analysis, only being female was significant associated with anxiety and depression in these patients. Conclusions: Incidence of anxiety and depression increased in DTCs prior to RAI therapy. Being female and ever-experienced RAI therapy significant influenced anxiety and depression. Based on these findings, anxiety and depression assessment should be an important part of pre-RAI therapy in DTCs, and appropriate psychological nursing intervention can be carried out for key patients.

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“…We believe that this phenomenon is related not only to the increased psychological burden of DTC patients due to RAI therapy itself, but also to the fact that patients stop thyroid hormone supplementation before RAI therapy and that hypothyroidism might lead to psychological symptoms. However, some studies have suggested that hypothyroidism is not significantly related to depression or anxiety [ 52 , 53 ]. Therefore, anxiety and depression in these patients are more likely to be related to fear of RAI therapy.…”

Section: Discussionmentioning

confidence: 99%

Anxiety and depression status prior to radioactive iodine therapy among differentiated thyroid cancer patients during the COVID‑19 pandemic

Qiao

Gao

Tong

et al. 2022

Support Care Cancer

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Objection The psychological health of thyroid cancer patients cannot be ignored; however, few studies have been conducted on the psychological status and influencing factors of thyroid cancer patients before radioactive iodine (RAI) therapy. The aim of this study was to investigate the incidence and risk factors for anxiety and depression in thyroid cancer patients prior to RAI therapy. Methods Clinical data were collected from patients with differentiated thyroid cancer (DTC) patients preparing for RAI therapy. Anxiety and depression were measured before RAI therapy using the Generalized Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). We used the chi-square test and logistic regression analysis to identify independent risk factors for anxiety and depression. Results A total of 112 patients with thyroid cancer were included. Of these, 72.32% ( n = 81) were female, with a mean age of 41.50 years. Anxiety and depression were reported by 46 (41.08%) and 38 (33.93%) patients, respectively. Based on the chi-square test and univariate logistic regression analysis, being female and having ever-experienced RAI therapy were significant risk factors for anxiety and depression among DTCs prior to RAI therapy. On multivariable analysis, the results of model 2 which included age, sex, education level, and ever suffering radioactive iodine therapy showed that being female was markedly associated with anxiety and depression in these patients, while having ever undergone RAI therapy was significantly related to anxiety but not depression. Conclusions The incidence of anxiety and depression among patients with DTC prior to RAI therapy were 41.08% and 33.93%, respectively. Being female and having ever experienced RAI therapy significantly influenced anxiety and depression. Based on these findings, anxiety and depression assessment should be an important part of pre-RAI therapy in patients with DTC, and appropriate psychological nursing intervention can be carried out for key patients. Supplementary information The online version contains supplementary material available at 10.1007/s00520-022-07422-7.

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Subclinical hypothyroidism and symptoms of depression: Evidence from the National Health and Nutrition Examination Surveys (NHANES)

Cited by 20 publications

References 21 publications

Pathophysiology and Management Possibilities of Thyroid-Associated Depression

Pathophysiology and Management Possibilities of Thyroid-Associated Depression

Anxiety and depression status prior to radioactive iodine therapy among differentiated thyroid cancer patients during the COVID‑19 epidemic

Anxiety and depression status prior to radioactive iodine therapy among differentiated thyroid cancer patients during the COVID‑19 pandemic

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