Depressive Symptoms and Major Depressive Disorder in Patients Affected by Subclinical Hypothyroidism A Cross-sectional Study
Depressive Symptoms and Major Depressive Disorder in Patients Affected by Subclinical Hypothyroidism A Cross-sectional Study
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DOI：
10.1097/nmd.0000000000000168
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发表时间：
2014-08-01
影响因子：
1.9
通讯作者：
Gambini, Orsola
中科院分区：
文献类型：
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作者：
Demartini, Benedetta;Ranieri, Rebecca;Gambini, Orsola
亚临床甲状腺功能减退症与抑郁症之间的关系仍存在争议。我们的目标是比较亚临床甲状腺功能减退症患者和对照组中抑郁症状和严重抑郁障碍的患病率。作者招募了123名在米兰圣保罗医院内分泌科接受随访的亚临床甲状腺功能减退症患者和123名由全科医生负责的未患甲状腺疾病的对照组。通过精神病学访谈、汉密尔顿抑郁量表(HAM-D)、蒙哥马利-阿斯伯格抑郁量表(MADRS)和血清促甲状腺激素、游离T-4和游离T-3水平对所有患者和对照组进行评估。患者还接受了甲状腺过氧化物酶抗体和甲状腺球蛋白抗体的筛查。亚临床甲减患者HAM-D和MADRS抑郁症状的发生率分别为63.4%和64.2%；22例患者(17.9%)被诊断为抑郁发作(《精神疾病诊断和统计手册》第四版，文本修订标准)。对照组HAM-D和MADRS抑郁症状发生率分别为27.6%和29.3%，只有7名对照组有抑郁发作。这两组之间抑郁症状的发生率在统计学上是不同的。这项研究强调了亚临床甲状腺功能减退症与抑郁症状之间的密切联系，这可能在临床实践中具有一些重要的诊断和治疗意义。
The relationship between subclinical hypothyroidism and depression is still controversial. Our objective was to compare the prevalence of depressive symptoms and major depressive disorder in a population of patients affected by subclinical hypothyroidism and a control group without thyroid disease. The authors enrolled 123 consecutive outpatients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology department of San Paolo Hospital in Milan and 123 controls without thyroid disease under the charge of general physicians. All patients and controls underwent an evaluation by means of a psychiatric interview; Hamilton Rating Scale for Depression (HAM-D); Montgomery-Asberg Depression Rating Scale (MADRS); and serum thyroid stimulating hormone, free T-4, and free T-3 levels. Patients were also screened for thyroid peroxidase antibodies and thyroglobulin antibodies. Patients affected by subclinical hypothyroidism had a prevalence of depressive symptoms of 63.4% at HAM-D and 64.2% at MADRS; 22 patients (17.9%) had a diagnosis of depressive episode (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria). The control group had a prevalence of depressive symptoms of 27.6% at HAM-D and 29.3% at MADRS, and only seven controls had a diagnosis of depressive episode. The prevalence of depressive symptoms between these two groups was statistically different. This study underlines a strong association between subclinical hypothyroidism and depressive symptoms, which could have some important diagnostic and therapeutic implications in the clinical practice.