Abnormal Thyroid Function in Patients with Mood Disorders: Prevalence and Associated Factors
Main Article Content
Abstract
Introduction : Mood disorders have high life-time prevalence and cause significant disabilities.
Hypothalamic-pituitary-thyroid (HPT) axis dysfunction has been reported in patients with mood
disorders, but the prevalence and its associations have yet to be established.
Objectives : To study the prevalence of abnormal thyroid function and associated factors in
patients with mood disorders
Material and Methods : In this retrospective descriptive study,medical records of patients with
mood disorders, including Major Depressive Disorder, Persistent Depressive Disorder
(Dysthymia), BipolarI Disorder, Bipolar II Disorders and Cyclothymia, from January 1st, 2011
to August 31st,2016 were reviewed. Collected data included demographic data, underlying
medical conditions, psychiatric diagnoses, medications, history of electroconvulsive therapy,
and results of thyroid function test (TFT). Statistical analyses were performed using STATA
10.1.
Results : From a total of 252 medical records,144 (57.14%) patients had complete data on
TFT, and 49 (34.03%) patients had abnormal TFT;40 patients had abnormal FT3; 13 patients
had abnormal TSH; and 2 patients had abnormal FT4. Factors including female gender and
the use of second generation antipsychotics showed statistically significant association with
abnormal TFT [adjusted OR 6.17 (95%CI2.5 - 15.23), p<0.001 and adjusted OR 2.3 (95%CI
1.06 - 5.02), p=0.036,respectively]
Conclusion : About one-third of patients with mood disorders had abnormal TFT, and female
gender and the use of second generation antipsychotics were associated with abnormal TFT.
Article Details
Articles submitted for consideration must not have been previously published or accepted for publication in any other journal, and must not be under review by any other journal.
References
Gilmour H, Patten SB.Depression and work impairment.Health Rep 2007; 18: 9-22.
World Health Organization [Internet]. Health Statistics and Information Systems. [cited 2019 Sep 10]. Available from https://www.who.int/ healthinfo/global_burden_disease/estimates/ en/index1.html
International Health Policy Program Foundation. International health policy program, strategic plan for the development of disease burden assessment index and population health. Disability-Adjusted Life Year: DALY in year 2009. Nonthaburi: The Graphico-Systems; 2012. (in Thai)
International Health Policy Program Foundation. International health policy program, strategic plan for the development of disease burden assessment index and population health. Disability-Adjusted Life Year: DALY in year 2013. Nonthaburi: The GraphicoSystems; 2015. (in Thai)
International Health Policy Program Foundation. International health policy program, strategic plan for the development of disease burden assessment index and population health. Disability-Adjusted Life Year: DALY in year 2014. Nonthaburi: The Graphico Systems; 2017. (in Thai)
Pilhatsch M, Marxen M,Winter C, Smolka MN, Bauer M. Hypothyroidism and mood disorders: integrating novel insights from brain imaging techniques. Thyroid Res 2011; 4(Suppl 1): S3.
Bauer M, Heinz A, Whybrow PC. Thyroid hormones, serotonin and mood: of synergy and significance in the adult brain.Mol Psychiatry 2002; 7: 140-56.
Whybrow PC, Prange AJ Jr., A hypothesis of thyroid-catecholamine-receptor interaction. Its relevance to affective illness. Arch Gen Psychiatry1981; 38:106-13.
Montero-Pedrazuela A, Venero C, Lavado- Autric R, Fernández-Lamo I, García-Verdugo JM, Bernal J, Guadaño-Ferraz A. Modulation of adult hippocampal neurogenesis by thyroid hormones: implications in depressive-like behavior. Molecular Psychiatry 2006;11:361-71.
Duval F, Mokrani MC, Bailey P, Correa H, Diep TS, Crocq MA,et al. Thyroid axis activity and serotonin function in major depressive episode. Psychoneuroendocrinology 1999; 24: 695-712.
HageMP, Azar ST.The Link between Thyroid Function and Depression.J Thyroid Res 2012.
Rush AJ, Giles DE, Schlesser MA, Orsulak PJ, Weissenburger JE, Fulton CL, et al. Dexamethasone response, thyrotropin-releasing hormone stimulation, rapid eye movement latency,and subtypes of depression. Biol Psychiatry 1997; 41:915-28.
Bahls SC, de Carvalho GA. The relation between thyroid function and depression: A Review. Rev Bras Psiquiatr 2004; 26: 40-8.
Abraham G, Milev R, Stuart Lawson J. T3 augmentation of SSRI resistant depression. J Affect Disord 2006; 91: 211-5.
Zhang Z, Li Q, Kang W, Tan Q, Gao C, Zhang F, et al. Differences in hypothyroidism between lithium-free and -treated patients with bipolar disorders. Life Sci 2006; 78: 771-6.
Azorin JM,Kaladjian A, Adida M, Hantouche EG, Hameg A, Lancrenon S, et al. Factors associated with rapid cycling in bipolar I manic patients: findings from a French national study. CNS Spectr 2008; 13: 780-7.
Thomsen AF, Kvist TK, Andersen PK, Kessing LV. Increased risk of affective disorder following hospitalization with hyperthyroidism— a register-based study. Eur J Endocrinol 2005; 152: 535-43.
Thomsen AF, Kvist TK, Andersen PK, Kessing LV. Increased risk of developing affective disorder in patients with hypothyroidism: a register-based study. Thyroid 2005; 15: 700-7.
Chhetry MG, Sapkota N, Ojha N, Thapa S, Pandey AK. Association of thyroid dysfunction with mood disorders in an OPD setting. J Psychiatrists’ Assoc Nepal 2014; 3: 23-8.
Radhakrishnan R, Calvin S, Singh JK, Thomas B, Srinivasan K. Thyroid dysfunction in major psychiatric disorders in a hospital based sample. Indian J Med Res2013;138:888-93.
Berent D, Zboralski K, Orzechowska A, Galecki P. Thyroid hormones association with depression severity and clinical outcome in patients with major depressive disorder. MolBiol Rep 2014; 41: 2419-25.
Ojha SP, Dhungana S, Chapagain M, Tulachan P. Association of thyroid dysfunction with depression in a teaching hospital. J Nepal Health Res Counc 2013; 11: 30-4.
Kim EY, Kim SH, Rhee SJ, Huh I, Ha K, Kim J, et al. Relationship between thyroid-stimulating hormone levels and risk of depression among general population with normal free T4 levels. Psychoneuroendocrinology 2015; 58: 114-9.
Bauer M, Glenn T, Pilhatsch M, Pfennig A, Whybrow PC. Gender differences in thyroid system function: relevance to bipolar disorder and its treatment. Bipolar Disord 2014; 16: 58-71.
Ahmadi-Abhari SA, Ghaeli P, Fahimi F, Esfahanian F, Farsam H, Dehpour AR, et al. Risk factors of thyroid abnormalities in bipolar patients receiving lithium: a case control study. BMC Psychiatry 2003; 3:1-5.
Flynn RW, MacDonald TM, Morris AD, Jung RT, Leese GP.The thyroid epidemiology, audit, and research study: thyroid dysfunction in the general population.J Clin Endocrinol Metab 2004; 89: 3879-84.
Khalil RB and Richa S. Thyroid Adverse Effects of Psychotropic Drugs: A Review. Clin Neuropharm 2011;34: 248-55.
Feret BM, Caley CF. Possible hypothyroidism associated withquetiapine. Ann Pharmacother 2000; 34:483-6.
Liappas J, Paparrigopoulos T, Mourikis I, Soldatos C. Hypothyroidism induced by quetiapine: a case report. J Clin Psychophar¬macol 2006; 26: 208-9.
Iversen T, Steen NE, Birkeland KI, Morch RH, Reponen EJ, Anderssen JF, et al. Antipsychotic drug use and thyroid function in patients with severe mental disorders. Schizophr Bull 2018; 44: S205-6.