Association between autoimmune thyroiditis and depressive disorder in psychiatric outpatients
Association between autoimmune thyroiditis and depressive disorder in psychiatric outpatients
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DOI：
10.1007/s00406-014-0529-1
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发表时间：
2015-02-01
影响因子：
4.7
通讯作者：
Reulbach, Udo
中科院分区：
文献类型：
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作者：
Degner, Detlef;Haust, Merle;Reulbach, Udo
甲状腺疾病常与精神疾病有关。自身免疫性甲状腺炎在普通人群中的患病率估计约为5- 14%。一项临床研究旨在评估自身免疫性甲状腺炎与精神科门诊患者抑郁之间的关系。在精神科门诊就诊的52名抑郁症患者和19名精神分裂症患者（作为对照组）被纳入研究。除检测促甲状腺激素（TSH）、游离三碘甲状腺原氨酸、游离甲状腺素、抗甲状腺过氧化物酶（抗tpo）抗体、抗甲状腺球蛋白抗体外，还行甲状腺超声检查。抑郁症患者病理性抗tpo水平升高的比例较高。此外，病理升高的抗tpo水平分布显著(chi (2) = 5.5；P = 0.019)，抑郁症患者（32.7%）与精神分裂症患者（5.3%）差异有统计学意义。在性别和年龄调整后的logistic回归中，与精神分裂症患者相比，单双相或双相患者合并自身免疫性甲状腺炎的优势比高10倍（95% CI = 1.2-85.3）。TSH基础水平在抑郁症患者和精神分裂症患者之间没有差异。我们的研究表明，抗tpo水平与单双相或双相抑郁症之间存在很强的相关性，抗tpo水平被认为是自身免疫性甲状腺炎（合并超声检查甲状腺低回声）的诊断价值。值得注意的是，常规测量的TSH水平本身不足以诊断这种相关的自身免疫性合并症。
Thyroid diseases are often associated with psychiatric disorders. The prevalence of autoimmune thyroiditis in the general population is estimated to be at about 5-14 %. A clinical study was conducted to evaluate the association between autoimmune thyroiditis and depression in psychiatric outpatients. Fifty-two patients with depression and nineteen patients with schizophrenia (serving as control group), attending a psychiatric outpatient unit, were included. In addition to the measurement of thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase (anti-TPO) antibodies, and anti-thyroglobulin antibodies, ultrasound examination of the thyroid gland was performed. The proportion of pathologically increased anti-TPO levels in patients with depression was high. Furthermore, the distribution of pathologically increased anti-TPO levels was significantly (chi (2) = 5.5; p = 0.019) different between patients with depression (32.7 %) and patients with schizophrenia (5.3 %). In a gender- and age-adjusted logistic regression, the odds ratio of uni- or bipolar patients with depression for an autoimmune thyroiditis was ten times higher (95 % CI = 1.2-85.3) when compared with schizophrenia patients. TSH basal level did not differ between patients with depression and patients with schizophrenia. Our study demonstrates a strong association between anti-TPO levels, which are considered to be of diagnostic value for autoimmune thyroiditis (in combination with a hypoechoic thyroid in ultrasonography) with uni- or bipolar depression. It should be noted that the routinely measured TSH level is not sufficient in itself to diagnose this relevant autoimmune comorbidity.