Comorbid thyroid disease in patients with major depressive disorder - results from the European Group for the Study of Resistant Depression (GSRD)
Comorbid thyroid disease in patients with major depressive disorder - results from the European Group for the Study of Resistant Depression (GSRD)
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DOI：
10.1016/j.euroneuro.2018.03.011
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发表时间：
2018-06-01
影响因子：
5.6
通讯作者：
Kasper, Siegfried
中科院分区：
文献类型：
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作者：
Fugger, Gernot;Dold, Markus;Kasper, Siegfried
这项由欧洲抵抗抑郁研究小组(GSRD)进行的多中心研究旨在探索重度抑郁障碍(MDD)和共病甲状腺疾病之间的联系。采用描述性统计、协方差分析(ANCOVA)和二元Logistic回归分析，对1410例合并甲状腺疾病和不合并甲状腺疾病的MDD患者的人口学和临床特征进行比较。我们确定甲状腺功能减退症的患病率为13.2%，甲状腺功能亢进症的患病率为1.6%。MDD合并甲状腺功能减退症的患者年龄明显较大，更有可能是女性，住院患者和患有其他慢性躯体疾病的患者。此外，当前抑郁发作开始时的MADRS评分显著较高，抑郁症的精神病性特征更明显。总体而言，MDD+合并甲状腺功能减退组的患者更倾向于使用联合药物治疗，例如普瑞巴林、抗精神病药物和情绪稳定剂。在MDD+合并甲亢组中，患者年龄明显较大，高加索血统，并被诊断为其他躯体合并症。总之，我们的分析表明，甲状腺功能异常，特别是甲状腺功能减退，与抑郁症的严重程度有关，并与抑郁症的不同心理病理特征有关。但合并甲状腺疾病对治疗反应无影响。在甲状腺功能减退的患者中，更有可能联合或加强精神药理药物的使用，特别是与抗精神病药物、情绪稳定剂和普瑞巴林一起使用。甲状腺疾病常合并其他慢性躯体疾病，包括高血压和心脏病。(C)2018年爱思唯尔和ECNP。版权所有。
This multicenter study of the European Group for the Study of Resistant Depression (GSRD) aimed to explore the association between major depressive disorder (MDD) and comorbid thyroid disease. A total number of 1410 patients' characteristics in terms of demographic and clinical information were compared between MDD subjects with and without concurrent thyroid disease using descriptive statistics, analyses of covariance (ANCOVA) and binary logistic regression analyses. We determined a point prevalence rate for comorbid hypothyroidism of 13.2% and 1.6% for comorbid hyperthyroidism respectively. Patients with MDD +comorbid hypothyroidism were significantly older, more likely to be female, inpatient and suffering from other comorbid chronic somatic conditions. Furthermore, MADRS score at onset of the current depressive episode was significantly higher, psychotic features of depression were more likely pronounced. Overall, patients in the MDD+comorbid hypothyroidism group were rather treated with a combination of drugs, for example, pregabalin, antipsychotic drugs and mood stabilizers. In the MDD+comorbid hyperthyroidism group patients were significantly older, of Caucasian origin and diagnosed with other somatic comorbidities. In conclusion, our analyses suggest that abnormal thyroid function, especially hypothyroidism, is linked to depression severity and associated with distinct psychopathologic features of depression. However, comorbid thyroid disease has no influence on treatment response. A combination or augmentation of psychopharmacological drugs, especially with antipsychotics, mood stabilizers and pregabalin is more likely in patients with hypothyroid conditions. Thyroid disorder is frequently found in combination with other chronic somatic diseases including hypertension and heart disease. (C) 2018 Elsevier B.V. and ECNP. All rights reserved.