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Simon GE, Moise N, Mohr DC. Management of Depression in Adults: A Review. JAMA 2024; 332:141-152. [PMID: 38856993 DOI: 10.1001/jama.2024.5756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Importance Approximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women. Observations Major depression is defined by depressed mood, loss of interest in activities, and associated psychological and somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment of severity as well as risk of self-harm, suspected bipolar disorder, psychotic symptoms, substance use, and co-occurring anxiety disorder. First-line treatments include specific psychotherapies and antidepressant medications. A network meta-analysis of randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving therapy, interpersonal therapy, brief psychodynamic therapy, and mindfulness-based psychotherapy all had at least medium-sized effects in symptom improvement over usual care without psychotherapy (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 [95% CI, 0.52-0.95]). A network meta-analysis of randomized clinical trials reported 21 antidepressant medications all had small- to medium-sized effects in symptom improvement over placebo (SMD ranging from 0.23 [95% CI, 0.19-0.28] for fluoxetine to 0.48 [95% CI, 0.41-0.55] for amitriptyline). Psychotherapy combined with antidepressant medication may be preferred, especially for more severe or chronic depression. A network meta-analysis of randomized clinical trials reported greater symptom improvement with combined treatment than with psychotherapy alone (SMD, 0.30 [95% CI, 0.14-0.45]) or medication alone (SMD, 0.33 [95% CI, 0.20-0.47]). When initial antidepressant medication is not effective, second-line medication treatment includes changing antidepressant medication, adding a second antidepressant, or augmenting with a nonantidepressant medication, which have approximately equal likelihood of success based on a network meta-analysis. Collaborative care programs, including systematic follow-up and outcome assessment, improve treatment effectiveness, with 1 meta-analysis reporting significantly greater symptom improvement compared with usual care (SMD, 0.42 [95% CI, 0.23-0.61]). Conclusions and Relevance Effective first-line depression treatments include specific forms of psychotherapy and more than 20 antidepressant medications. Close monitoring significantly improves the likelihood of treatment success.
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Affiliation(s)
- Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - Nathalie Moise
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Roa Dueñas OH, Hofman A, Luik AI, Medici M, Peeters RP, Chaker L. The Cross-sectional and Longitudinal Association Between Thyroid Function and Depression: A Population-Based Study. J Clin Endocrinol Metab 2024; 109:e1389-e1399. [PMID: 37855318 PMCID: PMC11031221 DOI: 10.1210/clinem/dgad620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/21/2023] [Accepted: 10/16/2023] [Indexed: 10/20/2023]
Abstract
CONTEXT An association of thyroid function with mood disorders has been widely suggested, but very few studies have examined this association longitudinally. OBJECTIVE We assessed the cross-sectional and longitudinal association between thyroid function and depression in a population-based cohort. METHODS A total of 9471 individuals were included in cross-sectional analyses, of whom 8366 had longitudinal data. At baseline, we assessed thyroid function using serum samples (thyrotropin [TSH], free thyroxine (FT4), and thyroid peroxidase antibodies) and depressive symptoms using the Centre for Epidemiologic Studies Depression (CES-D) scale. Incident depressive events (n = 1366) were continuously followed up with the CES-D and clinical interviews. We analyzed the cross-sectional association of thyroid function and thyroid disease with depressive symptoms using linear and logistic regression, and the longitudinal association with Cox proportional hazard models for depressive events. RESULTS Lower TSH levels and lower and higher FT4 levels were cross-sectionally associated with more depressive symptoms with a B value of -0.07 per 1 unit increase of natural log-transformed TSH (95% CI -0.11; -0.04). Furthermore, hypothyroidism was cross-sectionally associated with less depressive symptoms and hyperthyroidism with more depressive symptoms. Longitudinally, there was a U-shaped association between FT4 and incident depressive events but only in euthyroid participants. CONCLUSION We show a cross-sectional association between thyroid (dys)function with depressive symptoms, and a U-shaped association between FT4 and incident depressive events in euthyroid individuals. Our findings suggest an association of thyroid function with the risk of developing depression, albeit small. Reverse causation and additional underlying factors may also contribute to the association.
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Affiliation(s)
| | - Amy Hofman
- Department of Epidemiology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Trimbos Institute—The Netherlands Institute of Mental Health and Addiction, 3521 VS Utrecht, The Netherlands
| | - Marco Medici
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Epidemiology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
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Deng F, Fan X, Liao J, Tang R, Sun X, Lin J, Zhang G, Pan J. The effect of neuroendocrine abnormalities on the risk of psychiatric readmission after hospitalization for bipolar disorder: A retrospective study. Prog Neuropsychopharmacol Biol Psychiatry 2024; 130:110922. [PMID: 38114056 DOI: 10.1016/j.pnpbp.2023.110922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The correlation between the endocrine system and bipolar disorder(BD) has been well recognized, yet the influence of neuroendocrine hormones on readmission risk post-hospitalization for BD remains largely unexplored. This retrospective cohort study was to scrutinize the impact of neuroendocrine functionality on the readmission of patients with BD post-hospitalization for mental disorders. METHODS The dataset was derived from the electronic medical records of the First Affiliated Hospital of Jinan University in Guangzhou, China. Both univariate and multivariate logistic regression analysis were conducted on all patients hospitalized for BD, and from 1 January 2017 to October 2022. RESULTS Of the 1110 eligible patients, 83 and 141 patients experienced psychiatric readmissions within 90 and 180 days post-discharge, respectively. Multivariate analysis revealed that high serum TSH levels (aOR = 1.079; 95%CI = 1.003-1.160) and thyroid disease comorbidities (aOR = 2.899; 95%CI = 1.303-6.452) were independently correlated with the risk of 90-day readmission; while increased serum TSH levels (aOR = 1.179; 95%CI = 1.081-1.287) represented a risk factor for 180-day readmission. These results indicate that high serum TSH levels and thyroid disease comorbidities may contribute to an elevated readmission risk in patients with BD following hospitalization. CONCLUSION Routinely evaluating and intervening in thyroid function is crucial in the treatment of BD, as it may aid in preventing re-hospitalization.
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Affiliation(s)
- Fangyi Deng
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Psychiatry, Liyuan Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei 430077, China
| | - Xiaoxuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiwu Liao
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui Tang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xizhe Sun
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jingjing Lin
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guimei Zhang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiyang Pan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Puttaswamy SH, Nandibewur NP, Kumar P, Venkataiah V, Pinjar MJ. A Cross-Sectional Study of the Relationship Between Perceived Stress and Thyroid Function Among Apparently Normal Women in the Reproductive Age. Cureus 2024; 16:e55567. [PMID: 38576682 PMCID: PMC10993923 DOI: 10.7759/cureus.55567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND A substantial majority of women in India report experiencing stress frequently, with a significant number indicating a lack of time for relaxation. Women within a central productive age bracket often report higher stress levels. Chronic stress can lead to the development of autoimmune disorders affecting the thyroid gland. OBJECTIVE To evaluate the relationship between perceived stress and thyroid function among apparently normal women of reproductive age. MATERIALS AND METHODS The present study was conducted at the Vijayanagar Institute of Medical Sciences (VIMS) after obtaining clearance from the Institutional Ethical Committee and informed written consent from the participants. One hundred and fourteen working women aged 20-49 who consented to the study and had no personal or family history of medical illness or thyroid disease were randomly selected. Stress levels were measured using a Perceived Stress Scale (PSS), and thyroid parameters (total triiodothyronine [T3], total thyroxine [T4], and thyroid-stimulating hormone [TSH]) in blood samples were assessed by the electrochemical luminescence immunoassay method. Anthropometric parameters such as age and body mass index (BMI), as well as vital parameters like pulse rate and blood pressure, were measured for all participants. A detailed history was also recorded, including marital status, duration of married life, education, number of children, type of family, per capita income, phase of menstrual cycle, and dietary habits. RESULTS The Statistical Package for the Social Sciences (SPSS) software version 22.0 was used for statistical analysis. The analysis used Pearson's chi-square test, Student's t-test, and binary logistic regression. A positive correlation was observed between PSS and TSH (correlation coefficient "r" value = 0.060) without a significant p-value. Participants were divided into two groups based on TSH values: those with normal thyroid function (TSH <4.2 international units [IU]) and those with subclinical hypothyroidism (SCH) (TSH >4.2 IU). Both groups had total T3 and T4 levels within the normal reference range. A highly significant difference was observed for age, BMI, TSH, marital status, and duration of married life between women with normal thyroid function and those with SCH. No significant difference was found between the two groups for PSS. DISCUSSION Both acute and chronic stress affect thyroid function through the hypothalamus-pituitary-thyroid (HPT) axis and the hypothalamus-pituitary-adrenal (HPA) axis. Psychological and physiological stressors induce immune modulations that can lead to autoimmune thyroid diseases, resulting in hypothyroidism. CONCLUSION The study examined the link between stress and thyroid health in women of childbearing age, revealing a trend where higher stress levels corresponded with increased TSH levels, though not significantly. It also found that older age, higher BMI, and longer duration of marriage were linked to a greater occurrence of SCH. These findings underscore the potential influence of lifestyle factors and stress on thyroid function, suggesting that stress management and demographic factors should be considered in managing thyroid health. For women of reproductive age under high stress, routine monitoring of thyroid function could be beneficial for overall health maintenance.
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Affiliation(s)
- Sandhya H Puttaswamy
- Department of Physiology, Vijayanagar Institute of Medical Sciences, Ballari, IND
| | - Neeta P Nandibewur
- Department of Community Medicine, Vijayanagar Institute of Medical Sciences, Ballari, IND
| | - Pawan Kumar
- Department of Physiology, Vijayanagar Institute of Medical Sciences, Ballari, IND
| | - Vijay Venkataiah
- Department of Biochemistry, Vijayanagar Institute of Medical Sciences, Ballari, IND
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Wouters HJCM, Wolffenbuttel BHR, Muller Kobold AC, Links TP, Huls G, van der Klauw MM. Hypothyroidism, comorbidity and health-related quality of life: a population-based study. Endocr Connect 2023; 12:e230266. [PMID: 37855378 PMCID: PMC10692699 DOI: 10.1530/ec-23-0266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
Hypothyroidism is associated with a decreased health-related quality of life (HRQoL). We hypothesized that individuals with hypothyroidism (defined as use of thyroid hormone (TH)) and especially those having an impaired HRQoL are characterized by a high prevalence of comorbid disorders and that the impact of hypothyroidism and comorbidity on HRQoL is synergistic. Presence of comorbidity was based on data obtained using structured questionnaires, physical examination, biochemical measurements and verified medication use. Single morbidities were clustered into 14 different disease domains. HRQoL was measured using the RAND-36. Logistic regression analyses were used to determine the effect of TH use on the odds of having an affected disease domain and a lower score than an age- and sex-specific reference value for HRQoL. TH was used by 4537/14,7201 participants of the population-based Lifelines cohort with a mean (± s.d.) age of 51.0 ± 12.8 years (88% females). Eighty-five percent of the TH users had ≥1 affected disease domain in contrast to 71% of nonusers. TH use was associated with a higher odds of 13 out of 14 affected disease domains independent of age and sex. In a multivariable model, TH use was associated with a decreased HRQoL across six out of eight dimensions. No significant interactions between TH use and affected disease domains were observed. TH users with an impaired HRQoL had significantly more comorbidity than those not having an impaired HRQoL. In this large, population-based study, we demonstrated that TH users had more comorbidity than individuals not using TH. The coexistence of other chronic medical conditions in subjects with TH use led to further lowering of HRQoL in an additive manner.
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Affiliation(s)
- Hanneke J C M Wouters
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
- Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Anneke C Muller Kobold
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Thera P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Gerwin Huls
- Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
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Abstract
Traditional textbook physiology has ascribed unitary functions to hormones from the anterior and posterior pituitary gland, mainly in the regulation of effector hormone secretion from endocrine organs. However, the evolutionary biology of pituitary hormones and their receptors provides evidence for a broad range of functions in vertebrate physiology. Over the past decade, we and others have discovered that thyroid-stimulating hormone, follicle-stimulating hormone, adrenocorticotropic hormone, prolactin, oxytocin and arginine vasopressin act directly on somatic organs, including bone, adipose tissue and liver. New evidence also indicates that pituitary hormone receptors are expressed in brain regions, nuclei and subnuclei. These studies have prompted us to attribute the pathophysiology of certain human diseases, including osteoporosis, obesity and neurodegeneration, at least in part, to changes in pituitary hormone levels. This new information has identified actionable therapeutic targets for drug discovery.
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Affiliation(s)
- Mone Zaidi
- Center for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Departments of Medicine and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Tony Yuen
- Center for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Departments of Medicine and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Se-Min Kim
- Center for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Departments of Medicine and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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7
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Yilmaz D, Baykan O, Baykan H. The frequency of thyroid dysfunction in patients with a diagnosis of depressive disorder. Niger J Clin Pract 2023; 26:1575-1578. [PMID: 37929538 DOI: 10.4103/njcp.njcp_72_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Objective Thyroid dysfunctions are among the most common endocrine disorders in society. An increase or decrease in thyroid hormone levels may present with neurological and/or psychiatric symptoms. In this study, we aimed both to determine the prevalence of this disorder in our region by determining the frequency of thyroid dysfunction in patients diagnosed with major depressive disorder in our outpatient clinic and to raise awareness during the evaluation process of patients. Material and Method Thyroid-stimulating hormone (TSH) levels of 1035 patients diagnosed with major depressive disorder in our hospital between January 2020 and January 2022 were retrospectively scanned from the hospital information management system and those outside the reference ranges (0.38-5.33 mIU/L) were determined. Results It was observed that TSH was not within the reference ranges in approximately 7% of the patients diagnosed with depressive disorder. 1035 patients were included in the study. When the blood results of 1035 patients included in the study were examined retrospectively, 32 of them had TSH values below 0.38 mIU/L. TSH value was found to be above 5.33 mIU/L in 44 of them. Conclusion Obtained data have shown that thyroid dysfunctions can be encountered frequently in patients presenting with depressive complaints. It is thought that the evaluation of patients with depressive complaints in terms of thyroid dysfunction, and the treatment of the underlying thyroid dysfunction will contribute to the regression of psychiatric symptoms.
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Affiliation(s)
- D Yilmaz
- Mental Health and Diseases, Balikesir University, Faculty of Medicine, Balikesir, Turkey
| | - O Baykan
- Department of Medical Biochemistry, Balikesir University, Faculty of Medicine, Balikesir, Turkey
| | - H Baykan
- Mental Health and Diseases, Balikesir University, Faculty of Medicine, Balikesir, Turkey
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Liu S, Lin K, Zhang Y, Gao Y, Wang W, Du M, Jiang T, Zhou M, Zhang X. Prevalence and risk factors of psychotic symptoms in middle-aged patients with first-episode drug-naïve major depressive disorder: A large-scale cross-sectional study. J Affect Disord 2023; 325:102-109. [PMID: 36623569 DOI: 10.1016/j.jad.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Psychotic symptoms are common in patients with major depressive disorder (MDD). However, few studies have assessed the incidence of comorbid psychotic symptoms in first-episode drug naïve (FEDN) MDD patients. The present study aimed to evaluate the prevalence and risk factors of psychotic symptoms in a large sample of middle-aged Chinese patients with FEDN MDD. METHODS 813 middle-aged (age range 35 to 65 years) outpatients with FEDN MDD were recruited. The 17-item Hamilton Rating Scale for Depression (HAMD), the 14-item Hamilton Anxiety Rating Scale (HAMA), and the positive subscales of the Positive and Negative Syndrome Scale (PANSS) were used to assess patient anxiety, depression and psychotic symptoms, respectively. RESULTS The prevalence of psychotic symptoms in middle-aged patients with FEND MDD was 10.95 %. Multivariate logistic regression analysis showed that HAMA score, HAMD score, TSH, TC and BMI levels were significant predictors of psychotic symptoms in MDD middle-aged patients. The HAMA score and HAMD score predicted psychotic symptoms for both male and female middle-aged patients with MDD, while higher TSH, TC and BMI levels were correlated with psychotic symptoms only in female MDD patients. Furthermore, combining the HAMA score, HAMD score, and TSH could differentiate between psychotic major depression (PMD) and nonpsychotic major depression (NPMD) in middle-aged patients. CONCLUSIONS Psychotic symptoms among middle-aged patients with MDD can be identified by integrating clinical and biological variables as early as possible during the first time see a doctor.
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Affiliation(s)
- Shilin Liu
- Department of Neurocritical Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Keyi Lin
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Public Health Clinical Center, Hefei, Anhui, 230001, China
| | - Yang Zhang
- Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China
| | - Yaotian Gao
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Public Health Clinical Center, Hefei, Anhui, 230001, China
| | - Wei Wang
- Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China
| | - Mengcheng Du
- Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China
| | - Tao Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Public Health Clinical Center, Hefei, Anhui, 230001, China; Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Provincial Institute of Translational Medicine, Hefei, Anhui, 230001, China.
| | - Min Zhou
- Department of Neurocritical Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Rzeszutek M, Pięta M, Van Hoy A, Zawistowska M, Grymowicz M, Pięta W, Gołoś S, Walicka M. Coping profiles, depression, and body image anxiety during the Covid-19 pandemic: Comparative analysis of females with thyroid diseases and a non-clinical sample. PLoS One 2023; 18:e0282302. [PMID: 36857371 PMCID: PMC9977061 DOI: 10.1371/journal.pone.0282302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 02/12/2023] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES This study aimed to compare profiles of coping among females with thyroid disorders and females from a healthy control group regarding depression levels and body image anxiety. We also wanted to check whether subjectively experienced Covid-19-related psychological distress moderated the above-mentioned association in both groups of participants. METHOD The study sample comprised 564 females, of which 329 were diagnosed with a thyroid disease and 235 formed the healthy control group. Participants filled out paper-and-pencil or online versions of psychometric questionnaires to assess coping strategies, depression, and body image anxiety. RESULTS In general, we observed higher depression intensity and a higher level of body image anxiety among females with thyroid diseases than among the healthy control group. Latent profile analysis revealed adaptive vs. maladaptive coping profiles from both study samples. Depression symptoms were significantly higher if coping was maladaptive in both the clinical and control groups. Still, there were no significant differences in body image anxiety between participants with adaptive and maladaptive coping profiles. Covid-19-related distress did not moderate the link between coping profiles, depression, and body image anxiety in either group. CONCLUSION Greater focus should be placed on the role of body image in females struggling with thyroid diseases. Bodily therapy may help these patients to cope better with co-occurring thyroid diseases and mental disorders, whose relationship is still not fully understood.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki, Warsaw, Poland
- * E-mail:
| | - Małgorzata Pięta
- Faculty of Psychology, University of Warsaw, Stawki, Warsaw, Poland
| | - Angelika Van Hoy
- Faculty of Psychology, University of Warsaw, Stawki, Warsaw, Poland
| | | | - Monika Grymowicz
- Department of Gynecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Pięta
- Department of Gynecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Sara Gołoś
- Department of Gynecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Warsaw, Poland
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Jensen CZ, la Cour JL, Watt T, Kanters JK, Poulsen HE, Faber J, Ellervik C, Nygaard B. Association of Levothyroxine Treatment and Thyroid Peroxidase Antibodies with Antidepressant Use: A Danish Population-Based Longitudinal Study. Thyroid 2022; 32:1477-1487. [PMID: 36222609 DOI: 10.1089/thy.2022.0335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Subjects receiving levothyroxine (LT4) treatment have increased prevalence of depression, anxiety, and antidepressant use, but whether the underlying mechanism relates to thyroid autoimmunity is still unclarified. Methods: This is a population-based longitudinal study. Baseline biochemical and questionnaire data from the Danish General Suburban Population Study (GESUS) in 2010-2013 were linked with individual-level longitudinal data in national health registries. The aim was to investigate the associations between thyroid peroxidase antibodies (TPOAbs) and LT4 treatment, separately and through interaction, and at least one redeemed prescription for antidepressants. Logistic and Cox regression were used to evaluate initiation of antidepressant use before and after the baseline examination in GESUS, respectively. All exposures and covariates were fixed at the date of baseline examination. Thyroid autoimmunity was defined as serum TPOAbs >60 U/mL. Adjustments included sex, age, education, income, Charlson comorbidity index, smoking, and alcohol. Sensitivity analyses were performed for missing variables, exclusion of lithium use, exclusion of thyroid surgery, and conservative definitions for LT4 treatment and antidepressant use requiring at least two prescriptions. Results: We included 12,894 individuals, of whom 2353 (18%) had "past or current" antidepressant use at baseline, leaving 10,541 individuals at risk for incident antidepressant use after baseline. The median follow-up was 7.8 years during which 783 individuals (7.4% of 10,541 individuals) had incident antidepressant use. TPOAb positivity was not associated with "past or current" (odds ratio [OR] 0.90 [confidence interval, CI 0.78-1.03], p = 0.13) nor incident antidepressant use (hazard ratio [HR] 1.02 [CI 0.83-1.25], p = 0.88). LT4 treatment was associated with increased "past or current" antidepressant use (OR 1.33 [CI 1.10-1.62], p = 0.004) and increased incident antidepressant use (HR 1.38 [CI 1.03-1.85], p = 0.03). There were no interactions between the effects of TPOAb positivity and LT4 treatment on the use of antidepressants in logistic (p = 0.87) or Cox regression models (p = 0.82). Sensitivity analyses were robust, except that incident use of at least two redeemed antidepressant prescriptions was not statistically significant. Conclusions: LT4 treatment, but not TPOAb positivity, was associated with increased prevalent or incident antidepressant use with at least one prescription. Our findings do not support that thyroid autoimmunity is an important factor for antidepressant use in patients receiving LT4 treatment.
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Affiliation(s)
- Christian Zinck Jensen
- Center for Endocrinology and Metabolism, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Jeppe Lerche la Cour
- Center for Endocrinology and Metabolism, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Torquil Watt
- Center for Endocrinology and Metabolism, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Kim Kanters
- Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Enghusen Poulsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Endocrinology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Derpartment of Cardiology, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark
| | - Jens Faber
- Center for Endocrinology and Metabolism, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christina Ellervik
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Data Support, Region Zealand, Sorø, Denmark
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Birte Nygaard
- Center for Endocrinology and Metabolism, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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11
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Jehan C, Cartier D, Bucharles C, Anouar Y, Lihrmann I. Emerging roles of ER-resident selenoproteins in brain physiology and physiopathology. Redox Biol 2022; 55:102412. [PMID: 35917681 PMCID: PMC9344019 DOI: 10.1016/j.redox.2022.102412] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 12/23/2022] Open
Abstract
The brain has a very high oxygen consumption rate and is particularly sensitive to oxidative stress. It is also the last organ to suffer from a loss of selenium (Se) in case of deficiency. Se is a crucial trace element present in the form of selenocysteine, the 21st proteinogenic amino acid present in selenoproteins, an essential protein family in the brain that participates in redox signaling. Among the most abundant selenoproteins in the brain are glutathione peroxidase 4 (GPX4), which reduces lipid peroxides and prevents ferroptosis, and selenoproteins W, I, F, K, M, O and T. Remarkably, more than half of them are proteins present in the ER and recent studies have shown their involvement in the maintenance of ER homeostasis, glycoprotein folding and quality control, redox balance, ER stress response signaling pathways and Ca2+ homeostasis. However, their molecular functions remain mostly undetermined. The ER is a highly specialized organelle in neurons that maintains the physical continuity of axons over long distances through its continuous distribution from the cell body to the nerve terminals. Alteration of this continuity can lead to degeneration of distal axons and subsequent neuronal death. Elucidation of the function of ER-resident selenoproteins in neuronal pathophysiology may therefore become a new perspective for understanding the pathophysiology of neurological diseases. Here we summarize what is currently known about each of their molecular functions and their impact on the nervous system during development and stress.
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Affiliation(s)
- Cédric Jehan
- Rouen-Normandie University, UNIROUEN, Inserm, U1239, Neuroendocrine, Endocrine and Germinal Differenciation and Communication Laboratory, Mont-Saint-Aignan Cedex, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Dorthe Cartier
- Rouen-Normandie University, UNIROUEN, Inserm, U1239, Neuroendocrine, Endocrine and Germinal Differenciation and Communication Laboratory, Mont-Saint-Aignan Cedex, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Christine Bucharles
- Rouen-Normandie University, UNIROUEN, Inserm, U1239, Neuroendocrine, Endocrine and Germinal Differenciation and Communication Laboratory, Mont-Saint-Aignan Cedex, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Youssef Anouar
- Rouen-Normandie University, UNIROUEN, Inserm, U1239, Neuroendocrine, Endocrine and Germinal Differenciation and Communication Laboratory, Mont-Saint-Aignan Cedex, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Isabelle Lihrmann
- Rouen-Normandie University, UNIROUEN, Inserm, U1239, Neuroendocrine, Endocrine and Germinal Differenciation and Communication Laboratory, Mont-Saint-Aignan Cedex, France; Institute for Research and Innovation in Biomedicine, Rouen, France.
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12
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Anderson KS, Howard KJ, Haskard-Zolnierek KB, Pruin J, Deason RG. Using the Biopsychosocial Approach to Identify Factors Associated with Major Depressive Disorder for Individuals with Hypothyroidism. Issues Ment Health Nurs 2022; 43:755-765. [PMID: 35358004 DOI: 10.1080/01612840.2022.2053010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Previous research has found that major depressive disorder (MDD) commonly occurs in hypothyroid populations. The purpose of this study was to use the biopsychosocial model to investigate factors associated with MDD and hypothyroidism by comparing hypothyroid patients with MDD and without MDD. A sample of 386 participants with hypothyroidism completed both cognitive and psychosocial self-reported assessments along with a questionnaire rating the severity of common hypothyroid symptoms. Participants were divided into two groups (MDD and no MDD) using the diagnostic criteria of the Patient Health Questionnaire. Univariate comparisons were used to assess differences in the severity of physical, psychological, and social correlates in participants with and without MDD. Participants with MDD reported significantly worse symptom severity, increased stress, and disruptions of cognitive functioning. Compared to individuals without MDD, they also indicated poorer quality of life, doctor-patient relationships, and treatment adherence. Individuals with comorbid depression and hypothyroidism reported worse outcomes across physical symptoms, social factors, and psychological and cognitive states than individuals without MDD. Integrating depression screeners and independent treatment for MDD, in addition to the patient's hypothyroid treatment plan, may result in hypothyroid symptom relief and greater quality of life.
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Affiliation(s)
- Kennedy S Anderson
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Krista J Howard
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | | | - Julia Pruin
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Rebecca G Deason
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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Fitzgerald SP, Falhammar H. Redefinition of Successful Treatment of Patients With Hypothyroidism. Is TSH the Best Biomarker of Euthyroidism? Front Endocrinol (Lausanne) 2022; 13:920854. [PMID: 35784560 PMCID: PMC9243528 DOI: 10.3389/fendo.2022.920854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/10/2022] [Indexed: 12/14/2022] Open
Abstract
In recent years evidence has accumulated supporting a revised view of the nature of euthyroidism and the biomarkers of thyroid function. Within the normal range, variations in thyroid hormone levels are associated with variations in clinical parameters and outcomes. There are therefore no readily identified individually specific optimum levels of thyroid hormones for any individual. Levels around the middle of the normal population range may best reflect euthyroidism. These levels may have evolutionary advantages on the basis that adverse outcomes often increase with divergence from such levels, and physiological processes tend to minimise such inter-individual and intra-individual divergence. In populations of predominantly untreated individuals, levels of thyroid hormones and in particular levels of free thyroxine (FT4) correlate more often with clinical parameters than do levels of thyrotropin (TSH). Levels of thyroid hormones may therefore be regarded as the best available biomarkers of euthyroidism and dysthyroidism. It follows that 'subclinical hypothyroidism' (normal FT4/raised TSH levels), rather than being an accurate marker of peripheral tissue hypothyroidism is more a marker of decreased thyroid reserve and prognosis. The recent evidence suggests that treatment of hypothyroxinemia, regardless of the TSH level, and monitoring therapy using FT4 and/or triiodothyronine levels, depending on the replacement regime, may result in more successful treatment of hypothyroidism than relying on thyrotropin levels for patient selection and subsequent treatment monitoring. The equivalents of mid-range levels of thyroid hormones (especially FT4), adjusted by individual comorbidity concerns, may be rational general replacement targets. These implications of the new evidence may create opportunities for novel trials of thyroid replacement therapy.
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Affiliation(s)
- Stephen P. Fitzgerald
- The Departments of General Medicine and Endocrinology, The Royal Adelaide Hospital, Adelaide, SA, Australia
- School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Henrik Falhammar
- Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Menzies School of Health Research and Royal Darwin Hospital, Tiwi, NT, Australia
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14
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Wu Z, Jiang Y, Zhou D, Chen S, Zhao Y, Zhang H, Liu Y, Li X, Wang W, Zhang J, Kang X, Tao L, Gao B, Guo X. Sex-specific Association of Subclinical Hypothyroidism With Incident Metabolic Syndrome: A Population-based Cohort Study. J Clin Endocrinol Metab 2022; 107:e2365-e2372. [PMID: 35213715 DOI: 10.1210/clinem/dgac110] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Subclinical hypothyroidism is known to increase the risk of cardiovascular diseases and mortality. However, the longitudinal association between subclinical hypothyroidism and incident metabolic syndrome remains unclear. METHODS A total of 3615 participants from Beijing Health Management Cohort were enrolled from 2012 to 2014 and followed through 2019. People were placed into subclinical hypothyroidism and euthyroidism groups according to serum-free thyroxine and TSH concentrations. We used Cox proportional hazards regression models to investigate the relationship between TSH level and incident metabolic syndrome considering the modification effect of sex and age. RESULTS Of 3615 participants, 1929 were men (53.4%); mean (SD) age was 43.51 (11.73) years. Throughout the follow-up (median [interquartile range], 3.0 [2.8-3.2] years), 738 individuals developed metabolic syndrome. Subclinical hypothyroidism was significantly associated with metabolic syndrome development only in men, and the adjusted hazard ratio was 1.87 (95% CI, 1.21-2.90) compared with euthyroidism group. Of note, there was no increased risk of metabolic syndrome in people aged 50 years or older with subclinical hypothyroidism. CONCLUSIONS Subclinical hypothyroidism is associated with incident metabolic syndrome in young men. Further studies are needed to evaluate the targeted threshold and benefit of thyroid hormone replacement therapy for metabolic health.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
- Centre for Precision Health, Edith Cowan University, Perth 6027, Australia
| | - Yue Jiang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Di Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences; School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing 100068, China
| | - Yu Zhao
- Beijing Physical Examination Center, Beijing 100068, China
| | - Haiping Zhang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yue Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, 3086, Australia
| | - Wei Wang
- Centre for Precision Health, Edith Cowan University, Perth 6027, Australia
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing 100068, China
| | - Xiaoping Kang
- Beijing Xiaotangshan Hospital, Beijing 102211, China
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Bo Gao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
- Centre for Precision Health, Edith Cowan University, Perth 6027, Australia
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Relationship of free thyroxine and triiodothyronine on recurrence in maintenance therapy for bipolar depression. Asian J Psychiatr 2022; 71:103086. [PMID: 35316669 DOI: 10.1016/j.ajp.2022.103086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/20/2022] [Accepted: 03/09/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine whether thyroid function in the normal range is associated with recurrence of depressive or mania in bipolar disorder patients. METHODS 104 patients with bipolar disorder in maintenance therapy phase were assigned randomly to mood stabilizer combined with antidepressant group or mood stabilizer group. There were 52 patients in both groups respectively. Clinical symptoms were assessed at baseline, 3rd month, 6th month, 9th month, and 12th month using HAMD-17 and YMRS. Blood samples were analyzed for thyroid function. RESULTS There was no statistically significant difference of recurrence rate of depressive episode and mania episode at the end of the 12-months between mood stabilizer combined with antidepressant group and mood stabilizer group. There was significant relation of baseline TT4 (P = 0.020, HR = 0.948), FT3 (P = 0.035, HR = 2.055), and FT4 (P = 0.047, OR=0.769) with the recurrence of depressive episode in mood stabilizer group. The area under curve (AUC) of TT4, FT3, FT4 were 0.685, 0.613, 0.544, respectively. There was significant relation of baseline FT3 (P = 0.044,HR = 4.493) with the recurrence of mania episode for mood stabilizer combined with antidepressants group. The AUC of FT3 was 0.806. CONCLUSION Low level of TT4, FT4 and high level of FT3 within normal-range were related with the recurrence of depressive episode in the maintenance treatment with mood stabilizer of bipolar disorder. High level of FT3 within normal-range were related with recurrence of mania when mood stabilizer combined with antidepressants were used in the maintenance treatment of bipolar disorder.
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16
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Weng JJ, Wei JZ, Li M, Ning LP, Liu F, Wei YZ, Xiong WM, Zhang BJ, Lu JL, Jiang H, Lu QT, Qu SH. Prognostic value of hypothyroidism in patients undergoing intensity-modulated radiation therapy for nasopharyngeal carcinoma. Head Neck 2022; 44:1114-1123. [PMID: 35170140 DOI: 10.1002/hed.27006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/09/2021] [Accepted: 02/08/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effect of hypothyroidism and thyroxine replacement therapy on the prognosis of nasopharyngeal carcinoma (NPC) patients. METHODS The clinical data of 284 NPC patients, who received intensity-modulated radiation therapy (IMRT) between January 2011 and December 2016, were retrospectively analyzed. RESULTS Hypothyroidism occurred in 38% of patients. Patients with hypothyroidism had significantly better disease-free survival (DFS) (p = 0.002) and relapse-free survival (RFS) (p = 0.008). Multivariate analysis showed that hypothyroidism was a positive independent prognostic factor (DFS and RFS). Among the patients with hypothyroidism, thyroxine replacement therapy did not yield inferior survival (DFS, RFS, all p > 0.05). CONCLUSIONS The NPC patients with complete response are at risk of hypothyroidism, which is attributable to escalating dose. These patients experienced clinical hypothyroidism could be adequately treated with thyroid hormone replacement. Further investigation of the underlying biological mechanism and potential therapeutic implications are required.
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Affiliation(s)
- Jing-Jin Weng
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Jia-Zhang Wei
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Min Li
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Le-Ping Ning
- Department of Laboratory Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Fei Liu
- Research Center of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Yun-Zhong Wei
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Wei-Ming Xiong
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Ben-Jian Zhang
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Jin-Long Lu
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - He Jiang
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Qiu-Tian Lu
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Shen-Hong Qu
- Department of Otolaryngology & Head and Neck, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
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17
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Medical conditions and Attention-Deficit/Hyperactivity Disorder symptoms from early childhood to adolescence. Mol Psychiatry 2022; 27:976-984. [PMID: 34703026 DOI: 10.1038/s41380-021-01357-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/24/2022]
Abstract
The comorbidity between physical and mental health conditions is challenging and frequently goes unrecognized in practice. Associations between Attention-Deficit/Hyperactivity Disorder (ADHD) and physical conditions have been reported in youth. However, prior research failed to: (1) address the patterns of associations in early childhood, middle childhood, and adolescence within the same population sample; (2) consider a large set of physical disorders at the same time; (3) take confounders into account. Our goal was to assess the associations between ADHD symptoms and a broad set of physical conditions across developmental periods. This birth cohort study (n = 2057) is the first to explore the associations between ADHD and a wide range of medical conditions by encompassing the whole early development from 5 months to 17 years in the same sample and relying on innovative network analyses. We found significant associations between ADHD symptoms and several physical conditions, some of which were observed in early childhood, middle childhood, and adolescence (e.g., asthma, sleep problems) or were confounded by socioeconomic status or psychiatric comorbidities (e.g., body mass index, dental caries). The study calls for an effective integrated care model encompassing mental and general healthcare across the developmental period.
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18
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Lorena FB, do Nascimento BPP, Camargo ELRA, Bernardi MM, Fukushima AR, do N Panizza J, de B Nogueira P, Brandão MES, Ribeiro MO. Long-term obesity is associated with depression and neuroinflammation. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:537-548. [PMID: 34714995 PMCID: PMC10528574 DOI: 10.20945/2359-3997000000400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 06/18/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Obesity is characterized by a state of chronic, low-intensity systemic inflammation frequently associated with insulin resistance and dyslipidemia. METHODS Given that chronic inflammation has been implicated in the pathogenesis of mood disorders, we investigated if chronic obesity that was initiated early in life - lasting through adulthood - could be more harmful to memory impairment and mood fluctuations such as depression. RESULTS Here we show that pre-pubertal male rats (30 days old) treated with a high-fat diet (40%) for 8-months gained ~50% more weight when compared to controls, exhibited depression and anxiety-like behaviors but no memory impairment. The prefrontal cortex of the obese rats exhibited an increase in the expression of genes related to inflammatory response, such as NFKb, MMP9, CCl2, PPARb, and PPARg. There were no alterations in genes known to be related to depression. CONCLUSION Long-lasting obesity with onset in prepuberal age led to depression and neuroinflammation but not to memory impairment.
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Affiliation(s)
- Fernanda B Lorena
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil
- Medicina Translacional, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Bruna P P do Nascimento
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil
- Medicina Translacional, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Esther L R A Camargo
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil
- Departamento de Pesquisa e Extensão, Faculdade de Ciências da Saúde IGESP, São Paulo, SP, Brasil
| | - Maria M Bernardi
- Instituto de Ciências da Saúde, Universidade Paulista, São Paulo, SP, Brasil
| | - André R Fukushima
- Departamento de Pesquisa e Extensão, Faculdade de Ciências da Saúde IGESP, São Paulo, SP, Brasil
| | - Julia do N Panizza
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil
| | - Paula de B Nogueira
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil
| | - Marllos E S Brandão
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil
- Medicina Translacional, Universidade Federal de São Paulo, São Paulo, SP, Brasil
- Departamento de Pesquisa e Extensão, Faculdade de Ciências da Saúde IGESP, São Paulo, SP, Brasil
| | - Miriam O Ribeiro
- Programa de Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil,
- Medicina Translacional, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Kuś A, Kjaergaard AD, Marouli E, Fabiola Del Greco M, Sterenborg RB, Chaker L, Peeters RP, Bednarczuk T, Åsvold BO, Burgess S, Deloukas P, Teumer A, Ellervik C, Medici M. Thyroid Function and Mood Disorders: A Mendelian Randomization Study. Thyroid 2021; 31:1171-1181. [PMID: 33899528 PMCID: PMC7612998 DOI: 10.1089/thy.2020.0884] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Observational studies suggest that even minor variations in thyroid function are associated with the risk of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). However, it is unknown whether these associations are causal or not. We used a Mendelian randomization (MR) approach to investigate causal effects of minor variations in thyrotropin (TSH) and free thyroxine (fT4) levels on MDD and BD risk. Materials and Methods: We performed two-sample MR analyses using data from the largest publicly available genome-wide association studies on normal-range TSH (n = 54,288) and fT4 (n = 49,269) levels, MDD (170,756 cases, 329,443 controls) and BD (20,352 cases, 31,358 controls). Secondary MR analyses investigated the effects of TSH and fT4 levels on specific MDD and BD subtypes. Reverse MR was also performed to assess the effects of MDD and BD on TSH and fT4 levels. Results: There were no associations between genetically predicted TSH and fT4 levels and MDD risk, nor MDD subtypes and minor depressive symptoms. A one standard deviation increase in fT4 levels was nominally associated with an 11% decrease in the overall BD risk (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.80-0.98, p = 0.022) and a 13% decrease in the BD type 1 risk (OR = 0.87, CI = 0.75-1.00, p = 0.047). In the reverse direction, genetic predisposition to MDD and BD was not associated with TSH nor fT4 levels. Conclusions: Variations in normal-range TSH and fT4 levels have no effects on the risk of MDD and its subtypes, and neither on minor depressive symptoms. This indicates that depressive symptoms should not be attributed to minor variations in thyroid function. Borderline associations with BD and BD type 1 risks suggest that further clinical studies should investigate the effect of thyroid hormone treatment in BD.
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Affiliation(s)
- Aleksander Kuś
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Alisa D. Kjaergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Hedeager 3, 8000 Aarhus, Denmark
| | - Eirini Marouli
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ London, UK
- Centre for Genomic Health, Life Sciences, Queen Mary University of London, EC1M 6BQ London, UK
| | - M. Fabiola Del Greco
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lubeck, Via Galvani 31, 39100 Bolzano, Italy
| | - Rosalie B.T.M. Sterenborg
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Layal Chaker
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands
| | - Robin P. Peeters
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Bjørn O. Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Post box 8905, 7491 Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
| | - Stephen Burgess
- MRC Biostatistics Unit, Cambridge Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - Panos Deloukas
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ London, UK
- Centre for Genomic Health, Life Sciences, Queen Mary University of London, EC1M 6BQ London, UK
- Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, W.-Rathenau-Str. 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Fleischmannstr. 8, 17475 Greifswald, Germany
| | - Christina Ellervik
- Department of Laboratory Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, 02115 MA, USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 41, 2200 Copenhagen, Denmark
| | - Marco Medici
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
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Mukku SSR, Dahale AB, Muniswamy NR, Muliyala KP, Sivakumar PT, Varghese M. Geriatric Depression and Cognitive Impairment-An Update. Indian J Psychol Med 2021; 43:286-293. [PMID: 34385720 PMCID: PMC8327864 DOI: 10.1177/0253717620981556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Depression and cognitive impairment often coexist in older adults. The relation between depression and cognitive impairment is complex. The objective of this article is to review recent literature on cognitive impairment in older adults with depression and provide clinicians an update. METHODS We searched PubMed, Google Scholar, Science Direct, and Psych Info for the articles published in the English language related to late-life depression (LLD)/geriatric depression and cognitive impairment. We considered original research articles, relevant systematic reviews, chapters, and important conceptual articles published in the last 9 years (2011-2019). We selected relevant articles for this narrative review. CONCLUSION The concept pseudodementia, indicating depression with cognitive impairment mimicking dementia, is now seen only as a historical concept. The current literature strongly agrees with fact that cognitive deficits often exist in LLD. The cognitive deficits in depression were initially seen as trait marker; however, some recent studies suggest that cognitive deficits persist even in the remission phase. There is heterogeneity among the studies in terms of the nature of the cognitive deficits, but higher number of studies reported impairment in attention and executive function. LLD with cognitive deficits is at a higher risk of progression to dementia. In older adults, depression with cognitive impairments requires a comprehensive evaluation. Electroencephalography, event-related potentials, fluorodeoxyglucose-positron emission tomography, amyloid positron emission tomography, and CSF amyloid will supplement clinical evaluation in differentiating functional depressive disorder with cognitive impairment from depression with an underlying degenerative condition.
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Affiliation(s)
- Shiva Shanker Reddy Mukku
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ajit Bhalchandra Dahale
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Krishna Prasad Muliyala
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Palanimuthu Thangaraju Sivakumar
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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21
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Högqvist Tabor V, Högqvist Tabor M, Keestra S, Parrot JE, Alvergne A. Improving the Quality of Life of Patients with an Underactive Thyroid Through mHealth: A Patient-Centered Approach. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:182-194. [PMID: 34235505 PMCID: PMC8243709 DOI: 10.1089/whr.2021.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/13/2022]
Abstract
Background: Three hundred fifty million people worldwide suffer from underactive thyroid conditions, which can lead to infertility, obesity, heart disease, and impaired mental health when poorly managed. Although mobile health (mHealth) applications can be a useful solution for self-managing one's condition, the impact of digital solutions for improving the health of thyroid patients remains unknown. Methods: We used a mixed methods analysis to assess the ways in which a digital approach might benefit thyroid patients. A cross-sectional study was conducted among users of BOOST Thyroid, an mHealth application for patients with an underactive thyroid. We collected data using a modified Short Form 36 Health Survey Questionnaire to measure the impact of in the app on participants' perceived health and quality of life. Participants were asked to (1) score their quality of life before and after using the app, and (2) describe whether and how using the app helped them. Results: We enrolled 406 users (380 females and 26 males), aged 18-78 years. Most participants (95.8%) reported using the app was helpful; of which 68% reported it improved their quality of life and 70.8% reported it had a positive impact on their health. Participants who found the app useful experienced less symptoms and a lower intensity of remaining symptoms. A key factor reported by these participants as helping with managing their health is the information provided in the app. Conclusions: The results support the idea that a patient-centered treatment would benefit from including mHealth tools for a daily self-management of underactive thyroid condition, as it can increase health literacy and improve both one's health status and quality of life.
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Affiliation(s)
| | | | - Sarai Keestra
- School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom
- Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Alexandra Alvergne
- School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom
- ISEM, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France
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22
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Serotonin 2A receptor function and depression-like behavior in rats model of hypothyroidism. Exp Brain Res 2021; 239:2435-2444. [PMID: 34106297 DOI: 10.1007/s00221-021-06129-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
Hypothyroidism causes somatic, psychosocial and affective psychosis, including depression-like behaviors. In this study, (hypothyroidism group; HP group) adult male Sprague Dawley (SD) rats were induced to hypothyroidism after 5 weeks of exposure to 0.05% propylthiouracil (PTU) in potable water, control animals (CON group) were given the same amount of water. The following behavioral experiments were conducted, respectively: open-field test (OFT), forced swimming test (FST), tail suspension test (TST). TT[Formula: see text] and TT[Formula: see text] levels were measured after the behavior tests and the expression levels of 5-HT[Formula: see text] receptor and 5-HT[Formula: see text] receptor proteins were analyzed in the hippocampus and prefrontal cortex. The level of TT[Formula: see text] and TT[Formula: see text] in the HP group rats was much lower than that in the CON group. The hypothyroid rats also showed weight loss, much longer immobility time in tail suspension test and forced swimming test. Besides, 5 weeks of PTU administration was associated with significantly decreased expression levels of 5-HT[Formula: see text] receptor and 5-HT[Formula: see text] receptor proteins compared with control group, which were significantly negatively correlated with immobility time in FST and TST. In conclusion, our results suggest that hypothyroidism induces depressive behaviors through the influence of the serotonin system, and the decreased expression of the 5-HT[Formula: see text] receptor is an important cause of the depressive behaviors in hypothyroidism.
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23
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Martino G, Caputo A, Vicario CM, Feldt-Rasmussen U, Watt T, Quattropani MC, Benvenga S, Vita R. Alexithymia, Emotional Distress, and Perceived Quality of Life in Patients With Hashimoto's Thyroiditis. Front Psychol 2021; 12:667237. [PMID: 34045997 PMCID: PMC8144453 DOI: 10.3389/fpsyg.2021.667237] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/23/2021] [Indexed: 12/15/2022] Open
Abstract
Emotion-processing impairment represents a risk factor for the development of somatic illness, affecting negatively both health-related quality of life (HRQoL) and disease management in several chronic diseases. The present pilot study aims at (i) investigating the associations between alexithymia and depression, anxiety, and HRQoL in patients with Hashimoto's thyroiditis (HT); (ii) examining the association between these three psychological conditions together with HRQoL, and thyroid autoantibodies status as well as thyroid echotexture in patients with HT; and (iii) comparing the intensity of all these clinical psychological features in patients with HT versus controls. Twenty-one patients with serologically or ultrasonographically verified HT and 16 controls with non-toxic goiter or postsurgical hypothyroidism were recruited for this study. Serum thyrotropin (TSH) and free thyroxine, as well as thyroid autoantibodies (thyroglobulin antibodies and thyroid peroxidase antibodies), were assayed. Alexithymia, depression, anxiety, and HRQoL were assessed with Toronto Alexithymia Scale; Beck Depression Inventory, second edition; Hamilton Anxiety Rating Scale; and Health Survey Short-Form 36, respectively. A negative relationship between the difficulty to describe feelings and the cognitive component of depression was found (r = -0.46, p = 0.04). Besides, patients with seronegative HT had lower somatic anxiety than patients with HT who tested positive (r = -0.68, p = 0.01 and r = -0.59, p = 0.04, respectively). Besides, no statistically significant difference was found between patients with HT and controls with regard to somatic anxiety. The present study suggests the relevance of alexithymia in patients suffering from HT, which may be intertwined with a possible state of underreported depression that is mainly expressed through physical complaints. Promoting the capability to describe and communicate feelings could contribute to psychological elaboration and coping with the disease and, consequently, to the improvement of self-management and perceived HRQoL.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carmelo M. Vicario
- Department of Cognitive Sciences, Psychological, Pedagogical and Cultural Studies, University of Messina, Messina, Italy
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torquil Watt
- Department of Medical Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women’s Endocrine Health, University Hospital, AOU Policlinico “G. Martino,” Messina, Italy
| | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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24
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Zhao S, Chen Z, Wang X, Yao Z, Lu Q. Increased prevalence of subclinical hypothyroidism in female hospitalized patients with depression. Endocrine 2021; 72:479-485. [PMID: 33064261 DOI: 10.1007/s12020-020-02490-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/31/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUNDS Sex differences in depressive disorder (DD) and subclinical hypothyroidism (SCH) have been well recognized. However, few studies focus on the sex differences in DD patients with SCH. The purpose of this study is to address the sex differences in DD inpatients with SCH and further investigate the clinical characteristics and associations between DD and SCH among female and male depressed inpatients. METHODS A total of 1787 hospitalized patients with a diagnosis of DD were recruited. Depression was assessed using the Hamilton Depression Rating Scale-17 items (HAMD), and anxiety was assessed using the Hamilton Anxiety Rating Scale. Blood test, including serum thyroid hormone levels, was measured. According to different genders, associations between DD and the presence of SCH were estimated using binary logistic regression. RESULTS In the 1787 hospitalized patients with DD, the prevalence of SCH was 11.8%; the prevalence of SCH in female depressed inpatients is approximately two times that of male inpatients (14.6 vs. 7.4%, P < 0.05). Logistic regression showed that recurrent episodes and high BMI were associated with SCH in female inpatients (both P < 0.05). Spearman correlation analysis showed that thyroid stimulating hormone levels were associated with BMI (P < 0.05), total cholesterol levels (P < 0.05), and low-density lipoprotein cholesterol levels (P < 0.05) in female inpatients. CONCLUSIONS Our present study showed that the prevalence of SCH among female hospitalized patients with depression is approximately two times that of male inpatients. Recurrent and high-BMI female depressed inpatients are at high risk to develop SCH. More attention should be paid to the thyroid function of female inpatients with DD in future clinical work.
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Affiliation(s)
- Shuai Zhao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Zhilu Chen
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Xumiao Wang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, 210096, People's Republic of China.
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25
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Primary hypothyroidism and autoimmune thyroiditis alter the transcriptional activity of genes regulating neurogenesis in the blood of patients. Endocr Regul 2021; 55:5-15. [PMID: 33600668 DOI: 10.2478/enr-2021-0002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective. Thyroid hormones play an important role in the development and maturation of the central nervous symptom and their failure in the prenatal period leading to an irreversible brain damage. Their effect on the brain of adult, however, has not been fully studied. With the discovery of neurogenesis in the adult brain, many recent studies have been focused on the understanding the basic mechanisms controlling this process. Many neurogenesis regulatory genes are not only transcribed but also translated into the blood cells. The goal of our study was to analyze the transcriptional activity of neurogenesis regulatory genes in peripheral blood cells in patients with thyroid pathology.Methods. The pathway-specific PCR array (Neurotrophins and Receptors RT2 Profiler PCR Array, QIAGEN, Germany) was used to identify and validate the neurogenesis regulatory genes expression in patients with thyroid pathology and control group.Results. The results showed that GFRA3, NGFR, NRG1, NTF3, NTRK1, and NTRK2 significantly decreased their expression in patients with autoimmune thyroiditis with rising serum of autoantibodies. The patients with primary hypothyroidism, as a result of autoimmune thyroiditis and postoperative hypothyroidism, had significantly lower expression of FGF2, NGFR, NRG1, and NTF3. The mRNA level of CNTFR was markedly decreased in the group of patients with postoperative hypothyroidism. No change in the ARTN, PSPN, TFG, MT3, and NELL1 expression was observed in any group of patients.Conclusion. The finding indicates that a decrease in thyroid hormones and a high level of autoantibodies, such as anti-thyroglobulin antibody and anti-thyroid peroxidase antibody, affect the expression of mRNA neurogenesis-regulated genes in patients with thyroid pathology.
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26
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Alzghoul BN, Amer FN, Barb D, Innabi A, Mardini MT, Bai C, Alzghoul B, Al-Hakim T, Singh N, Buchanan M, Serchuck L, Gomez Manjarres D, Woodmansee WW, Maier LA, Patel DC. Prevalence and characteristics of self-reported hypothyroidism and its association with nonorgan-specific manifestations in US sarcoidosis patients: a nationwide registry study. ERJ Open Res 2021; 7:00754-2020. [PMID: 33816601 PMCID: PMC8005680 DOI: 10.1183/23120541.00754-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/24/2020] [Indexed: 12/15/2022] Open
Abstract
Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis. We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with nonorgan-specific manifestations. 14% of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multiorgan sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal gland involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR) 1.3, 95% CI 1.01-1.6), antidepressant use (aOR 1.3, 95% CI 1.1-1.7), obesity (aOR 1.7, 95% CI 1.4-2.1), sleep apnoea (aOR 1.7, 95% CI 1.3-2.2), chronic fatigue syndrome (aOR 1.5, 95% CI 1.2-2) and was borderline associated with fibromyalgia (aOR 1.3, 95% CI 1-1.8). Physical impairment was more common in patients with hypothyroidism. Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multiorgan sarcoidosis, fatigue and depression.
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Affiliation(s)
- Bashar N. Alzghoul
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Farah N. Amer
- Dept of Internal Medicine, University of Central Florida/North Florida Regional Medical Center, Gainesville, FL, USA
| | - Diana Barb
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Ayoub Innabi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Mamoun T. Mardini
- Dept of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
- Dept of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Chen Bai
- Dept of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bara Alzghoul
- Dept of Internal Medicine, University of Kentucky, Lexington, KY, USA
| | | | - Noopur Singh
- Foundation for Sarcoidosis Research, Chicago, IL, USA
| | | | | | - Diana Gomez Manjarres
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Whitney W. Woodmansee
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Lisa A. Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Dept of Medicine, School of Medicine, Dept of Environmental/Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - Divya C. Patel
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
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Abstract
Depression is among the most prevalent mental disorders worldwide, and a substantial proportion of patients do not respond adequately to standard antidepressants. Our understanding of the pathophysiology of depression is no longer limited to the chemical imbalance of neurotransmitters, but also involves the interplay of proinflammatory modulators in the central nervous system, as well as folate metabolism. Additional factors such as stress and metabolic disorders also may contribute. Multiple inflammatory, metabolic, and genetic markers have been identified and may provide critical information to help clinicians individualize treatments for patients to achieve optimal outcomes. Recent advancements in research have clarified underlying causes of depression and have led to possible new avenues for adjunctive treatment. Among these is L-methylfolate, a medical food that is thought to enhance synthesis of monoamines (serotonin, norepinephrine, and dopamine), suppress inflammation, and promote neural health. Clinical studies that assessed supplemental use of L-methylfolate in patients with usual care-resistant depression found that it resulted in improved outcomes. Patients with selective serotonin reuptake inhibitor-resistant depression, and particularly subgroups with biomarkers of inflammation or metabolic disorders or folate metabolism-related genetic polymorphisms (or ≥2 of these factors), had the best responses. Considering this, the goals of this review are to 1) highlight recent advances in the pathophysiology of major depressive disorder as it pertains to folate and associated biomarkers and 2) establish the profiles of patients with depression who could benefit most from supplemental use of L-methylfolate.
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28
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Basım P, Argun D, Özdenkaya Y. Self-reported medication adherence in differentiated thyroid cancer survivors: Role of illness perception and medication beliefs. Head Neck 2020; 43:428-437. [PMID: 33009715 DOI: 10.1002/hed.26488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/18/2020] [Accepted: 09/21/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To investigate medication adherence (MA) to Levothyroxine in differentiated thyroid cancer survivors and analyze the related factors for nonadherence. METHODS The Medication Adherence Report Scale (MARS), Hospital Anxiety and Depression Scale (HAD), Brief Illness Perception Questionnaire (B-IPQ), and Beliefs about Medicines Questionnaire (BMQ) were used to assess MA. RESULTS Nonadherence was reported in 77 of 197 patients (39.1%). Socioeconomic status and education levels were found to be significantly related to MA. The HAD scores, all items of B-IPQ, and BMQ were associated with MA and showed a correlation with the MARS scores. The primary predictors of MA were greater confidence in treatment modality (odds ratio [OR]: 0.48, 95% confidence interval (CI): 0.37-0.63) and greater belief that the medication had minimal risk of harm (OR: 3.35, 95% CI: 1.50-7.49). CONCLUSIONS Special attention should be paid to educational programs for differentiated thyroid carcinoma patients concerning the effectiveness and low risk of harm of medication in order to improve MA.
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Affiliation(s)
- Pelin Basım
- Department of General Surgery, Medipol University, Istanbul, Turkey
| | - Derya Argun
- Department of Internal Medicine, Medipol University, Istanbul, Turkey
| | - Yaşar Özdenkaya
- Department of General Surgery, Medipol University, Istanbul, Turkey
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29
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Gunes NA. Evaluation of anxiety and depression in patients with thyroid function disorder. Rev Assoc Med Bras (1992) 2020; 66:979-985. [PMID: 32844932 DOI: 10.1590/1806-9282.66.7.979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/06/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES We aim to determine the anxiety and depression levels of patients treated for hypothyroidism who assumed euthyroid status. These patients also frequently attend family medicine outpatient clinics. METHODS This study was conducted on 76 euthyroid volunteer participants (patient groups) who were treated for hypothyroidism and followed-up and 22 healthy volunteers (control group). Questionnaires were administered to all participants to assess anxiety and depression levels. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to all the groups. In addition, BAI sub-parameters were evaluated in detail. RESULTS At least mild depression was detected in 54.5% of the first group, 41.7% of the second group, and 33.3% of the third group. When the BDI and BAI total scores of the participants in different groups were compared, statistically significant differences were determined. Statistically significant results were detected related to different BAI sub-parameters between the patient groups and in comparison to the fourth group. CONCLUSIONS We found that patients were predisposed to anxiety and depression even if they were euthyroid. When the sub-parameters of BAI were evaluated in detail, we observed that the duration of the disease significantly affected some anxiety-related symptoms.
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Affiliation(s)
- Nurcan Akbas Gunes
- Department of Family Medicine, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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30
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Zhou W, Brumpton B, Kabil O, Gudmundsson J, Thorleifsson G, Weinstock J, Zawistowski M, Nielsen JB, Chaker L, Medici M, Teumer A, Naitza S, Sanna S, Schultheiss UT, Cappola A, Karjalainen J, Kurki M, Oneka M, Taylor P, Fritsche LG, Graham SE, Wolford BN, Overton W, Rasheed H, Haug EB, Gabrielsen ME, Skogholt AH, Surakka I, Davey Smith G, Pandit A, Roychowdhury T, Hornsby WE, Jonasson JG, Senter L, Liyanarachchi S, Ringel MD, Xu L, Kiemeney LA, He H, Netea-Maier RT, Mayordomo JI, Plantinga TS, Hrafnkelsson J, Hjartarson H, Sturgis EM, Palotie A, Daly M, Citterio CE, Arvan P, Brummett CM, Boehnke M, de la Chapelle A, Stefansson K, Hveem K, Willer CJ, Åsvold BO. GWAS of thyroid stimulating hormone highlights pleiotropic effects and inverse association with thyroid cancer. Nat Commun 2020; 11:3981. [PMID: 32769997 PMCID: PMC7414135 DOI: 10.1038/s41467-020-17718-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/08/2020] [Indexed: 12/11/2022] Open
Abstract
Thyroid stimulating hormone (TSH) is critical for normal development and metabolism. To better understand the genetic contribution to TSH levels, we conduct a GWAS meta-analysis at 22.4 million genetic markers in up to 119,715 individuals and identify 74 genome-wide significant loci for TSH, of which 28 are previously unreported. Functional experiments show that the thyroglobulin protein-altering variants P118L and G67S impact thyroglobulin secretion. Phenome-wide association analysis in the UK Biobank demonstrates the pleiotropic effects of TSH-associated variants and a polygenic score for higher TSH levels is associated with a reduced risk of thyroid cancer in the UK Biobank and three other independent studies. Two-sample Mendelian randomization using TSH index variants as instrumental variables suggests a protective effect of higher TSH levels (indicating lower thyroid function) on risk of thyroid cancer and goiter. Our findings highlight the pleiotropic effects of TSH-associated variants on thyroid function and growth of malignant and benign thyroid tumors.
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Affiliation(s)
- Wei Zhou
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA.
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA.
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA.
| | - Ben Brumpton
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Thoracic Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Omer Kabil
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Division of Metabolism Endocrinology and Diabetes, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | | | - Josh Weinstock
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Matthew Zawistowski
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jonas B Nielsen
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Internal Medicine, Division of Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Layal Chaker
- Erasmus MC Academic Center for Thyroid Diseases, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marco Medici
- Erasmus MC Academic Center for Thyroid Diseases, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, 6500HB, Nijmegen, The Netherlands
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Silvia Naitza
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche Monserrato, Monserrato, Italy
| | - Serena Sanna
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche Monserrato, Monserrato, Italy
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ulla T Schultheiss
- Faculty of Medicine and Medical Center, Institute of Genetic Epidemiology, University of Freiburg, Freiburg, Germany
- Faculty of Medicine and Medical Center, Department of Medicine IV-Nephrology and Primary Care, University of Freiburg, Freiburg, Germany
| | - Anne Cappola
- Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Juha Karjalainen
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Mitja Kurki
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Morgan Oneka
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Peter Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Lars G Fritsche
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sarah E Graham
- Department of Internal Medicine, Division of Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Brooke N Wolford
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - William Overton
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Humaira Rasheed
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Eirin B Haug
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Maiken E Gabrielsen
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Anne Heidi Skogholt
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Ida Surakka
- Department of Internal Medicine, Division of Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - George Davey Smith
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anita Pandit
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Tanmoy Roychowdhury
- Department of Internal Medicine, Division of Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Whitney E Hornsby
- Department of Internal Medicine, Division of Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jon G Jonasson
- Landspitali-University Hospital, 101, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland
- The Icelandic Cancer Registry, 105, Reykjavik, Iceland
| | - Leigha Senter
- Division of Human Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, 43210, USA
| | - Sandya Liyanarachchi
- Department of Cancer Biology and Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, 43210, USA
| | - Matthew D Ringel
- Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Li Xu
- Department of Head and Neck Surgery, and Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030, USA
| | - Lambertus A Kiemeney
- Radboud University Medical Centre, Radboud Institute for Health Sciences, 6500HB, Nijmegen, The Netherlands
| | - Huiling He
- Department of Cancer Biology and Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, 43210, USA
| | - Romana T Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, 6500HB, Nijmegen, The Netherlands
| | | | - Theo S Plantinga
- Department of Pathology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, 6500HB, Nijmegen, The Netherlands
| | | | | | - Erich M Sturgis
- Department of Head and Neck Surgery, and Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030, USA
| | - Aarno Palotie
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Mark Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Cintia E Citterio
- Division of Metabolism Endocrinology and Diabetes, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología y Biotecnología/Cátedra de Genética, Buenos Aires, C1113AAD, Argentina
- CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), C1120AAR, Buenos Aires, Argentina
| | - Peter Arvan
- Division of Metabolism Endocrinology and Diabetes, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Chad M Brummett
- Division of Pain Medicine, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Michael Boehnke
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Albert de la Chapelle
- Department of Cancer Biology and Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, 43210, USA
| | - Kari Stefansson
- deCODE genetics/AMGEN, 101, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, 7600, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, 7600, Norway
| | - Cristen J Willer
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
- Department of Internal Medicine, Division of Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Bjørn Olav Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, 7600, Norway.
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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Bidirectional association between blood pressure and depressive symptoms in young and middle-age adults: A cohort study. Epidemiol Psychiatr Sci 2020; 29:e142. [PMID: 32665058 PMCID: PMC7372173 DOI: 10.1017/s2045796020000542] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS To evaluate the bidirectional relationship between blood pressure (BP) and depressive symptoms using a large prospective cohort study. METHODS Prospective cohort study was performed in 276 244 adults who participated in a regular health check-up and were followed annually or biennially for up to 5.9 years. BP levels were categorised according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. Depressive symptoms were assessed using Centre for Epidemiologic Studies-Depression (CESD) questionnaire and a cut-off score of ≥25 was regarded as case-level depressive symptoms. RESULTS During 672 603.3 person-years of follow-up, 5222 participants developed case-level depressive symptoms. The multivariable-adjusted hazard ratios (HRs) [95% confidence interval (CI)] for incident case-level depressive symptoms comparing hypotension, elevated BP, hypertension stage 1 and hypertension stage 2 to normal BP were 1.07 (0.99-1.16), 0.93 (0.82-1.05), 0.89 (0.81-0.97) and 0.81 (0.62-1.06), respectively (p for trend <0.001). During 583 615.3 person-years of follow-up, 27 787 participants developed hypertension. The multivariable-adjusted HRs (95% CI) for incident hypertension comparing CESD 16-24 and ⩾25 to CESD < 16 were 1.05 (1.01-1.11) and 1.12 (1.03-1.20), respectively (p for trend <0.001) and in the time-dependent models, corresponding HRs (95% CI) were 1.12 (1.02-1.24) and 1.29 (1.10-1.50), respectively (p for trend <0.001). CONCLUSIONS In this large cohort study of young and middle-aged individuals, higher BP levels were independently associated with a decreased risk for developing case-level depressive symptoms and depressive symptoms were also associated with incident hypertension. Further studies are required to elucidate the mechanisms underlying the bidirectional association between BP levels and incident depression.
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32
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Wytrychiewicz K, Pankowski D, Janowski K, Benoit CE, Bargiel-Matusiewicz K, Pisula E, Walicka M. The role of beliefs about the impact of illness on fertility and close relationships for psychopathological symptoms in women treated for hypothyroidism. J Clin Psychol 2020; 76:2314-2328. [PMID: 32592617 DOI: 10.1002/jclp.23011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVE As demonstrated in a pilot study, hypothyroidism has a highly stressful impact on some areas of functioning. This study aims to evaluate the connection between illness-related beliefs (IRBs) and the impact of hypothyroidism on fertility and close relationships, which were the strongest stressors, and the level of depressive, anxiety, and anger symptoms. METHODS Two hundred and thirteen women being treated for hypothyroidism took part in an online survey and completed the modified Hospital Anxiety and Depression Scale, Hypothyroidism Symptoms Severity rating scales, and a measure of IRBs. Other relevant clinical data were also collected. RESULT Mean levels of thyroid-stimulating hormone indicated that the women were euthyroid. Four groups of participants were identified based on IRBs. The group holding a strong IRB about the negative impact of illness only on close relationships scored significantly higher on depressive symptoms than women in the other groups. The group holding strong IRBs about the negative impact of illness on both close relationships and fertility scored significantly higher on anxiety symptoms than the women in the other groups. Regression analysis showed that IRBs about the negative impact of hypothyroidism predicted anxiety, depressive, and anger symptoms. CONCLUSIONS Negative IRBs about the impact of illness on fertility and close relationships contribute to increased levels of emotional distress symptoms in women being treated for hypothyroidism.
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Affiliation(s)
- Kinga Wytrychiewicz
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.,Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Daniel Pankowski
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.,Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Konrad Janowski
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Charles E Benoit
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | | | - Ewa Pisula
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
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Lang X, Hou X, Shangguan F, Zhang XY. Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese. J Affect Disord 2020; 263:507-515. [PMID: 31759671 DOI: 10.1016/j.jad.2019.11.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/14/2019] [Accepted: 11/02/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND The coexistence of subclinical hypothyroidism (SCH) and depression has been intensively examined in the patients receiving thyroxine or antidepressant treatment. This study aimed to investigate the prevalence and clinical correlates of severe SCH in Chinese first-episode drug naïve patients with major depressive disorder (MDD). METHODS Using a cross-sectional design, we recruited a total of 1706 MDD patients. Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale (HAMD). Severity of anxiety and psychiatric symptoms were evaluated by the Hamilton Anxiety Rating Scale (HAMA) and the Positive and Negative Syndrome Scale (PANSS), respectively. Serum thyroid function parameters were measured by a chemiluminescence immunoassay. Based on the serum thyroid stimulating hormone (TSH) level, SCH was further divided into mild (TSH < 10 mIU/L) and severe SCH (TSH ≥ 10 mIU/L). RESULTS More patients with severe SCH had severe anxiety, psychotic symptoms, suicide attempts (all p < 0.001), compared with those without severe SCH. Logistic regression showed that suicide attempts and psychiatric symptoms were associated with severe SCH (both p < 0.001). Multiple linear regression showed that age (p < 0.05), BMI (p < 0.001), HAMD score (p < 0.001), HAMA score (p < 0.001), PANSS positive subscore (p = 0.001) and CGI score (p = 0.001) were associated with TSH levels. CONCLUSION Our findings suggest that suicide attempts and psychiatric symptoms may be associated with severe SCH. Moreover, severe anxiety, depressive and psychotic symptoms, as well as older age and higher BMI are possibly related to elevated TSH levels.
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Affiliation(s)
- XiaoE Lang
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Xin Hou
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Fangfang Shangguan
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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34
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Hirtz R, Keesen A, Hölling H, Hauffa BP, Hinney A, Grasemann C. No Effect of Thyroid Dysfunction and Autoimmunity on Health-Related Quality of Life and Mental Health in Children and Adolescents: Results From a Nationwide Cross-Sectional Study. Front Endocrinol (Lausanne) 2020; 11:454. [PMID: 32982959 PMCID: PMC7492205 DOI: 10.3389/fendo.2020.00454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022] Open
Abstract
Background: In adults, a significant impact of thyroid dysfunction and autoimmunity on health-related quality of life (HRQoL) and mental health is described. However, studies in children and adolescents are sparse, underpowered, and findings are ambiguous. Methods: Data from 759 German children and adolescents affected by thyroid disease [subclinical hypothyroidism: 331; subclinical hyperthyroidism: 276; overt hypothyroidism: 20; overt hyperthyroidism: 28; Hashimoto's thyroiditis (HT): 68; thyroid-peroxidase antibody (TPO)-AB positivity without apparent thyroid dysfunction: 61] and 7,293 healthy controls from a nationwide cross-sectional study ("The German Health Interview and Examination Survey for Children and Adolescents") were available. Self-assessed HRQoL (KINDL-R) and mental health (SDQ) were compared for each subgroup with healthy controls by analysis of covariance considering questionnaire-specific confounding factors. Thyroid parameters (TSH, fT4, fT3, TPO-AB levels, thyroid volume as well as urinary iodine excretion) were correlated with KINDL-R and SDQ scores employing multiple regression, likewise accounting for confounding factors. Results: The subsample of participants affected by overt hypothyroidism evidenced impaired mental health in comparison to healthy controls, but SDQ scores were within the normal range of normative data. Moreover, in no other subgroup, HRQoL or mental health were affected by thyroid disorders. Also, there was neither a significant relationship between any single biochemical parameter of thyroid function and HRQoL or mental health, nor did the combined thyroid parameters account for a significant proportion of variance in either outcome measure. Importantly, the present study was sufficiently powered to identify even small effects in children and adolescents affected by HT, subclinical hypothyroidism, and hyperthyroidism. Conclusions: In contrast to findings in adults, and especially in HT, there was no significant impairment of HRQoL or mental health in children and adolescents from the general pediatric population affected by thyroid disease. Moreover, mechanisms proposed to explain impaired mental health in thyroid dysfunction in adults do not pertain to children and adolescents in the present study.
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Affiliation(s)
- Raphael Hirtz
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Raphael Hirtz
| | - Anne Keesen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Berthold P. Hauffa
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Corinna Grasemann
- Department of Pediatrics and Center for Rare Diseases Ruhr CeSER, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
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TSH and T4 Levels in a Cohort of Depressive Patients. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:117-122. [PMID: 32874682 PMCID: PMC7445649 DOI: 10.12865/chsj.46.02.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/22/2020] [Indexed: 11/18/2022]
Abstract
Depression is a significant contributor to the overall burden of disease on a global scale. Thyroid hormones thyroxine (T4) and triiodothyronine (T3) have been shown to play a critical role in the development and normal function of the brain. It has been suggested that dysregulation of thyroid function could be associated with depression, especially hypothyroidism, but not all studies support this hypothesis. We enrolled a cohort of 96 subjects with major depressive disorder and tested TSH and FT4 levels for 80 of them in order to assess the status of the hypothalamic-pituitary-thyroid axis (HPT). We found 7 cases (8.75% of the tested) of subclinical hyperthyroidism and 1 case (1.25%) of overt hyperthyroidism. While we did not find supporting evidence for association between TSH and FT4 levels and depression, our findings question whether screening depressive patients for HPT axis anomalies could be clinically relevant, if anything, in a regional context.
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Romero-Gómez B, Guerrero-Alonso P, Carmona-Torres JM, Notario-Pacheco B, Cobo-Cuenca AI. Mood Disorders in Levothyroxine-Treated Hypothyroid Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234776. [PMID: 31795239 PMCID: PMC6926863 DOI: 10.3390/ijerph16234776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 02/07/2023]
Abstract
Background: Hypothyroidism has several symptoms (weight gain, arrhythmias, mood changes, etc.). The aims of this study were (1) to assess the prevalence of anxiety and depression in levothyroxine-treated hypothyroid women and in women without hypothyroidism; (2) to identify variables associated with anxiety and depression. Methods: A case-control study was performed with 393 women. Case-group: 153 levothyroxine-treated hypothyroid women. Control-group: 240 women without hypothyroidism. Convenience sampling. Instrument: The Hamilton Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. Results: The prevalence of anxiety in levothyroxine-treated hypothyroid women was higher than in women without hypothyroidism (29.4% vs. 16.7%, χ2 p < 0.001). The prevalence of depression in the case group was higher than in the control group (13.1% vs. 4.6%, χ2 p < 0.001). Levothyroxine-treated hypothyroid women were more likely to have anxiety (OR = 2.08, CI: 1.28-3.38) and depression (OR = 3.13, IC = 1.45-6.45). Conclusion: In spite of receiving treatment with levothyroxine, women with hypothyroidism are more likely to have depression and anxiety. Health professionals need to assess the mood of women with hypothyroidism. Although levothyroxine is a good treatment for the symptoms of hypothyroidism, it may not be enough to prevent development or persistence of depression and anxiety by itself.
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Affiliation(s)
- Benjamín Romero-Gómez
- Hospital El Tomillar de Sevilla, Servicio Andaluz de Salud (SAS), 41500 Alcalá de Guadaira, Spain;
| | | | - Juan Manuel Carmona-Torres
- Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain;
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla la Mancha, 45005 Toledo, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
- Correspondence: ; Tel./Fax: +34-925-268800 (ext. 5819)
| | - Blanca Notario-Pacheco
- Facultad de Enfermería de Cuenca, Universidad de Castilla la Mancha, 16071 Cuenca Toledo, Spain;
- Grupo de Investigación CESS, Universidad de Castilla la Mancha, 16071 Cuenca, Spain
| | - Ana Isabel Cobo-Cuenca
- Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain;
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla la Mancha, 45005 Toledo, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
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Fattouh N, Hallit S, Salameh P, Choueiry G, Kazour F, Hallit R. Prevalence and factors affecting the level of depression, anxiety, and stress in hospitalized patients with a chronic disease. Perspect Psychiatr Care 2019; 55:592-599. [PMID: 30825393 DOI: 10.1111/ppc.12369] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/15/2019] [Accepted: 02/17/2019] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To report the prevalence of psychological/mental disorders and determine the factors associated with them in hospitalized patients with chronic diseases. DESIGN AND METHODS This was as cross-sectional study. One hundred and fifty patients were randomly selected from one hospital having at least one chronic disease. FINDINGS The rate of depression, anxiety, and stress in our sample were 21.3%, 61.3%, and 48.7%, respectively. Benign prostate hypertrophy, dysthyroidism, avoidance of thoughts and feelings as a coping mechanism, and a longer hospital stay were associated with higher depression. Hypertension, female gender, and a higher education level were associated with higher anxiety. Female gender and a longer stay in hospital were predictors of stress. PRACTICE IMPLICATIONS Hospitalized patients with chronic illnesses have high levels of psychological distress, showing the importance of getting psychological counseling in these settings.
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Affiliation(s)
- Nour Fattouh
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Georges Choueiry
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,Department of Epidemiology & Biostatistics, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Francois Kazour
- Faculty of Philosophy and Human Sciences, Holy Spirit University, Kaslik, Lebanon.,Faculty of Sciences, Lebanese University, Fanar, Lebanon.,Department of Psychiatry, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,INSERM U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, Parc de Grandmont, Tours, France.,Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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38
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Cui L, Gong X, Chang M, Yin Z, Geng H, Song Y, Lv J, Feng R, Wang F, Tang Y, Xu K. Association of LHPP genetic variation (rs35936514) with structural and functional connectivity of hippocampal-corticolimbic neural circuitry. Brain Imaging Behav 2019; 14:1025-1033. [PMID: 31250265 DOI: 10.1007/s11682-019-00140-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A single nucleotide polymorphism at the LHPP gene (rs35936514) has been reported to be associated with major depressive disorder (MDD) in genome-wide association studies. We conducted a neuroimaging analysis to explore whether and which brain neural systems are affected by LHPP variation. Since LHPP variants seem to be associated with the hippocampus, we assessed the relationship between rs35936514 variation and structural-functional connectivity within a hippocampal-corticolimbic neural system implicated in MDD. A total of 122 Chinese subjects were divided into a CC homozygous group (CC genotype, n = 60) and a T allele-carrier group (CT/TT genotypes, n = 62). All subjects participated in resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) scans. Structural and functional connectivity data analyses were then performed. Compared to the CC group, the T allele-carrier group showed significantly higher fractional anisotropy (FA) values in the fornix as well as increased functional connectivity from the hippocampus to the rostral part of the anterior cingulate cortex (rACC). Moreover, a significant negative correlation between fornix FA value and hippocampus-rACC functional connectivity was identified (P < 0.05). These findings suggest that there is a relationship between rs35936514 variation and both structural and functional hippocampal-corticolimbic neural system involvement in MDD. LHPP may play an important role in the neuropathophysiology of MDD.
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Affiliation(s)
- Lingling Cui
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaohong Gong
- State Key Laboratory of Genetic Engineering and MOE key Laboratory of Contemporary Anthroology, School of Life Sciences, Fudan University, Shanghai, China
| | - Miao Chang
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Zhiyang Yin
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haiyang Geng
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yanzhuo Song
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Lv
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ruiqi Feng
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Fei Wang
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- The Research Institute for Brain Functional Imaging, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.
- Department of Geriatrics and Psychiatry, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.
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Petnehazy E, Buchinger W. [Hashimoto thyroiditis, therapeutic options and extrathyroidal options - an up-to-date overview]. Wien Med Wochenschr 2019; 170:26-34. [PMID: 30919217 DOI: 10.1007/s10354-019-0691-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/08/2019] [Indexed: 12/15/2022]
Abstract
Hashimoto's thyroiditis is one of the most common organspecific autoimune diseases and the most frequent cause of hypothyroidism in areas with sufficient iodine supply. Excessively stimulated T cells CD4+ and their differentiated cells are known to play a key role in the pathogenesis. It is currently accepted that on the one hand genetic susceptibility, environmental factors, existential factors (gender difference) play an important role, on the other hand gut and intestinal microbiota seem to contribute to its development too. Diagnosis requires a detailed medical history, sonography, and blood analysis of thyroid function and thyroid antibodies. In case of an overt or subclinical hypothyroidism long-term or lifelong levothyroxine replacement may be needed, with a special focus on phases with an additional demand like during pregnancy. There are multifactorial reasons for poor response to therapy despite normal TSH levels in blood sampling like co-morbidities (other organspecific autoimmune diseases, psychiatric diseases), lack of vitamin and trace elements. Pharmacogenomic and pharmacokinetic factors may impact on levothyroxine bioavailability, also thyroid hormone resistance and transport- or conversion disorder due to insulin resistance or adrenal insufficiency for example. The relations between thyroid function, mental status and psychiatric disorders seem to be complex and the mechanisms underlying the interactions remain to be clarified. Continuing research in biochemical, genetic and neuroimaging fields are needed.
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Affiliation(s)
- Eva Petnehazy
- Innere Medizin, Krankenhaus der Barmherzigen Brüder Graz, Standort Graz-Eggenberg, Bergstrasse 27, 8020, Graz, Austria. .,Institut für Schilddrüsendiagnostik und Nuklearmedizin Gleisdorf, Businesspark 2, 8200, Gleisdorf, Austria.
| | - Wolfgang Buchinger
- Institut für Schilddrüsendiagnostik und Nuklearmedizin Gleisdorf, Businesspark 2, 8200, Gleisdorf, Austria
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Törring O, Watt T, Sjölin G, Byström K, Abraham-Nordling M, Calissendorff J, Cramon PK, Filipsson Nyström H, Hallengren B, Holmberg M, Khamisi S, Lantz M, Wallin G. Impaired Quality of Life After Radioiodine Therapy Compared to Antithyroid Drugs or Surgical Treatment for Graves' Hyperthyroidism: A Long-Term Follow-Up with the Thyroid-Related Patient-Reported Outcome Questionnaire and 36-Item Short Form Health Status Survey. Thyroid 2019; 29:322-331. [PMID: 30667296 DOI: 10.1089/thy.2018.0315] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hyperthyroidism is known to have a significant impact on quality of life (QoL), at least in the short term. The purpose of the present study was to assess QoL in patients 6-10 years after treatment for Graves' disease (GD) with radioiodine (RAI) compared to those treated with thyroidectomy or antithyroid drugs (ATD) as assessed with both thyroid-specific Thyroid-Related Patient-Reported Outcome (ThyPRO) questionnaire and general (36-item Short Form Health Status) QoL survey. METHODS The study evaluated 1186 GD patients in a sub-cohort from an incidence study 2003-2005 who had been treated according to routine clinical practice at seven participating centers. Patients were included if they had returned the ThyPRO (n = 975) and/or the 36-item Short Form Health Status survey questionnaire (n = 964) and informed consent at follow-up. Scores from ThyPRO were compared to scores from a general population sample (n = 712) using multiple linear regression adjusting for age and sex as well as multiple testing. Treatment-related QoL outcome for ATD, RAI, and surgery were compared, including adjustment for the number of treatments received, sex, age, and comorbidity. RESULTS Regardless of treatment modality, patients with GD had worse thyroid-related QoL 6-10 years after diagnosis compared to the general population. Patients treated with RAI had worse thyroid-related and general QoL than patients treated with ATD or thyroidectomy on the majority of QoL scales. Sensitivity analyses supported the relative negative comparative effects of RAI treatment on QoL in patients with hyperthyroidism. CONCLUSIONS GD is associated with a lower QoL many years after treatment compared to the general population. In a previous small randomized controlled trial, no difference was found in patient satisfaction years after ATD, RAI, or surgery. Now, it is reported that in a large non-randomized cohort, patients who received RAI had adverse scores on ThyPRO and 36-item Short Form Health Status survey. These findings in a Swedish population are limited by comparison to normative data from Denmark, older age, and possibly a more prolonged course in those patients who received RAI, and a lack of information regarding thyroid status at the time of evaluation. The way RAI may adversely affect QoL is unknown, but since the results may be important for future considerations regarding treatment options for GD, they need to be substantiated in further studies.
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Affiliation(s)
- Ove Törring
- 1 Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- 2 Division of Endocrinology, Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden
| | - Torquil Watt
- 3 Department of Medical Endocrinology Rigshospitalet, Copenhagen, Denmark
- 4 Internal Medicine Herlev Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gabriel Sjölin
- 5 Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Kristina Byström
- 6 Department of Medicine, University Hospital and Örebro University, Örebro, Sweden
| | - Mirna Abraham-Nordling
- 7 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jan Calissendorff
- 7 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- 8 Department of Endocrinology, Metabolism, and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Per Karkov Cramon
- 3 Department of Medical Endocrinology Rigshospitalet, Copenhagen, Denmark
- 4 Internal Medicine Herlev Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helena Filipsson Nyström
- 9 Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- 10 Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Bengt Hallengren
- 11 Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
- 12 Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Mats Holmberg
- 9 Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- 13 ANOVA, Karolinska University Hospital, Stockholm, Sweden
| | - Selwan Khamisi
- 14 Department of Endocrinology, Uppsala University Hospital, Uppsala, Sweden
- 15 Institution of Internal Medicine, Uppsala University, Uppsala, Sweden
| | - Mikael Lantz
- 11 Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
- 12 Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Göran Wallin
- 5 Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- 7 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Mazi B, Kaddour O, Al-Badr A. Depression symptoms in women with pelvic floor dysfunction: a case-control study. Int J Womens Health 2019; 11:143-148. [PMID: 30863189 PMCID: PMC6390859 DOI: 10.2147/ijwh.s187417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose In this study, we aimed to estimate the prevalence of depression symptoms in women with pelvic floor dysfunction (PFD) and to assess their quality of life (QOL). Patients and methods A case-control study assessing depression and its severity in women with PFD (urinary incontinence, pelvic organ prolapse, and fecal incontinence) was conducted. Patients attending the Urogynecology Department of the Women's Specialized Hospital, King Fahad Medical City, were requested to complete the self-reported Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Beck Inventory Scale for Depression. Women presenting with no PFD symptoms were recruited from other clinics as controls. Results Data of 100 women diagnosed with PFD (mean age, 45.18±10.50 years) and 100 control participants (mean age, 45.14±13.03 years; P=0.644) were collected. Patients with PFD showed significantly higher (7.3%) body mass index (BMI) (32.59±6.22 kg/m2) than controls (30.37±8.08 kg/m2) (OR, 1.044, 95% CI: 1.001-1.091; P=0.043). Patients with PFD exhibited a threefold higher prevalence of depression symptoms than controls (43% vs 14%, respectively; P<0.001). QOL scores in patients with PFD were significantly higher in patients with depression (P-values, 0.024 to <0.001). Conclusion There is a significant association between depression and PFD, and QOL scores in patients with PFD were significantly higher in patients with depression.
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Affiliation(s)
- Baraa Mazi
- National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ouhoud Kaddour
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia, .,Prince Naif Healthcare Research Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ahmed Al-Badr
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia, .,Urogynecology & Pelvic Reconstructive Surgery Department, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia,
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Choi HG, Park B, Ji YB, Tae K, Song CM. Depressive Disorder in Thyroid Cancer Patients after Thyroidectomy: A Longitudinal Follow-up Study Using a National Cohort. Otolaryngol Head Neck Surg 2018; 160:239-245. [DOI: 10.1177/0194599818802190] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective The present study compared the frequency of depressive disorder in patients with thyroid cancer who had undergone thyroidectomy with the frequency in control individuals. Study Design Retrospective population-based cohort study. Setting This study used data from the Korean Health Insurance Review and Assessment Service–National Sample Cohort. Subject and Methods A total of 3609 participants with thyroid cancer who had undergone thyroidectomy between 2003 and 2011 were enrolled in this study and matched 1:4 with 14,436 control participants by age, sex, income, and region of residence. The cumulative incidence of postoperative depressive disorder was evaluated over a period of 10 years after the thyroidectomies and compared with the incidence in controls. Depressive disorder was diagnosed by a psychiatrist. Results The incidence of depressive disorder was significantly higher in the thyroid cancer with thyroidectomy group than in the controls up to postoperative year 1. A subgroup analysis showed the same higher incidence of depressive disorder in the thyroid cancer group than controls for up to 1 year after operations in young adult (≤44 years old), female, urban, and low-income groups. However, the incidence was elevated only in the year of the thyroidectomies themselves in middle-aged and older, rural, and high-income groups. Conclusion Patients with thyroid cancer who undergo thyroidectomy have depressive disorder more frequently than normal controls. However, the frequency of depressive disorder after thyroidectomy recovers in a shorter period in middle-aged or older, high-income, and rural-dwelling patients, compared to younger, low-income, and urban-dwelling patients.
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Affiliation(s)
- Hyo Geun Choi
- Department of Otolaryngology–Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Bumjung Park
- Department of Otolaryngology–Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Yong Bae Ji
- Department of Otolaryngology–Head & Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Kyung Tae
- Department of Otolaryngology–Head & Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Chang Myeon Song
- Department of Otolaryngology–Head & Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
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Tylee DS, Sun J, Hess JL, Tahir MA, Sharma E, Malik R, Worrall BB, Levine AJ, Martinson JJ, Nejentsev S, Speed D, Fischer A, Mick E, Walker BR, Crawford A, Grant SF, Polychronakos C, Bradfield JP, Sleiman PMA, Hakonarson H, Ellinghaus E, Elder JT, Tsoi LC, Trembath RC, Barker JN, Franke A, Dehghan A, Faraone SV, Glatt. SJ. Genetic correlations among psychiatric and immune-related phenotypes based on genome-wide association data. Am J Med Genet B Neuropsychiatr Genet 2018; 177:641-657. [PMID: 30325587 PMCID: PMC6230304 DOI: 10.1002/ajmg.b.32652] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/21/2018] [Accepted: 05/22/2018] [Indexed: 12/18/2022]
Abstract
Individuals with psychiatric disorders have elevated rates of autoimmune comorbidity and altered immune signaling. It is unclear whether these altered immunological states have a shared genetic basis with those psychiatric disorders. The present study sought to use existing summary-level data from previous genome-wide association studies to determine if commonly varying single nucleotide polymorphisms are shared between psychiatric and immune-related phenotypes. We estimated heritability and examined pair-wise genetic correlations using the linkage disequilibrium score regression (LDSC) and heritability estimation from summary statistics methods. Using LDSC, we observed significant genetic correlations between immune-related disorders and several psychiatric disorders, including anorexia nervosa, attention deficit-hyperactivity disorder, bipolar disorder, major depression, obsessive compulsive disorder, schizophrenia, smoking behavior, and Tourette syndrome. Loci significantly mediating genetic correlations were identified for schizophrenia when analytically paired with Crohn's disease, primary biliary cirrhosis, systemic lupus erythematosus, and ulcerative colitis. We report significantly correlated loci and highlight those containing genome-wide associations and candidate genes for respective disorders. We also used the LDSC method to characterize genetic correlations among the immune-related phenotypes. We discuss our findings in the context of relevant genetic and epidemiological literature, as well as the limitations and caveats of the study.
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Affiliation(s)
- Daniel S. Tylee
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
| | - Jiayin Sun
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
| | - Jonathan L. Hess
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
| | - Muhammad A. Tahir
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
| | - Esha Sharma
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Bradford B. Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, U.S.A
| | - Andrew J. Levine
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, U.S.A
| | - Jeremy J. Martinson
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, PA, U.S.A
| | | | - Doug Speed
- Aarhus Institute for Advanced Studies and University College London, London, U.K
| | - Annegret Fischer
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Eric Mick
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, U.S.A
| | - Brian R. Walker
- BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K
| | - Andrew Crawford
- School of Social and Community Medicine, MRC Integrated Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA, U.S.A
| | - Struan F.A. Grant
- Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA, U.S.A
- Division of Endocrinology and Diabetes, The Children’s Hospital of Philadelphia, Philadelphia, PA, U.S.A
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A
- Institute of Diabetes, Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Constantin Polychronakos
- Endocrine Genetics Laboratory, Department of Pediatrics and the Child Health Program of the Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jonathan P. Bradfield
- Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA, U.S.A
- Quantinuum Research LLC, San Diego, CA, U.S.A
| | - Patrick M. A. Sleiman
- Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA, U.S.A
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Hakon Hakonarson
- Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA, U.S.A
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - Eva Ellinghaus
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - James T. Elder
- Department of Dermatology, Veterans Affairs Hospital, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lam C. Tsoi
- Department of Dermatology, Veterans Affairs Hospital, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Richard C. Trembath
- Division of Genetics and Molecular Medicine, King’s College London, London, UK
| | - Jonathan N. Barker
- Department of Biostatistics and Epidemiology, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Abbas Dehghan
- Department of Biostatistics and Epidemiology, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London
| | | | | | - Stephen V. Faraone
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Stephen J. Glatt.
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab); Departments of Psychiatry and Behavioral Sciences & Neuroscience and Physiology; SUNY Upstate Medical University; Syracuse, NY, U.S.A
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Vitamin D Level, Thyroid Function, and Maternal Depression in Late Pregnancy. WOMEN’S HEALTH BULLETIN 2018. [DOI: 10.5812/whb.68256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Comorbid thyroid disease in patients with major depressive disorder - results from the European Group for the Study of Resistant Depression (GSRD). Eur Neuropsychopharmacol 2018; 28:752-760. [PMID: 29705022 DOI: 10.1016/j.euroneuro.2018.03.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/01/2018] [Accepted: 03/12/2018] [Indexed: 02/02/2023]
Abstract
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.
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Kim JS, Zhang Y, Chang Y, Ryu S, Guallar E, Shin YC, Shin H, Lim SW, Cho J. Subclinical Hypothyroidism and Incident Depression in Young and Middle-Age Adults. J Clin Endocrinol Metab 2018; 103:1827-1833. [PMID: 29408972 DOI: 10.1210/jc.2017-01247] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/26/2018] [Indexed: 02/10/2023]
Abstract
BACKGROUND The role of subclinical hypothyroidism in the development of depression remains controversial. We examined the prospective association between subclinical hypothyroidism and incident depressive symptoms. METHODS We conducted a prospective cohort study of 220,545 middle-age adults without depression who had undergone at least two comprehensive health examinations between 1 January 2011 and 31 December 2014. Thyroid-stimulating hormone, free triiodothyronine (FT3), and free thyroxine (FT4) levels were measured using an electrochemiluminescent immunoassay. The study outcome was incident depressive symptoms, defined as a Center for Epidemiologic Studies-Depression score >16. RESULTS During a median follow-up period of 2 years, incident depressive symptoms occurred in 7323 participants. The multivariable-adjusted hazard ratio for incident depressive symptoms comparing subclinical hypothyroid and euthyroid participants was 0.97 (95% confidence interval, 0.87 to 1.09). Similarly, among euthyroid participants (n = 87,822), no apparent association was found between thyroid hormone levels and an increased risk of incident depressive symptoms. CONCLUSIONS No apparent association was found between subclinical hypothyroidism and incident depressive symptoms in a large prospective cohort of middle-age men and women.
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Affiliation(s)
- Ji Sun Kim
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Yiyi Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yoosoo Chang
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Young-Chul Shin
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hocheol Shin
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se-Won Lim
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Juhee Cho
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
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Bortolotto VC, Pinheiro FC, Araujo SM, Poetini MR, Bertolazi BS, de Paula MT, Meichtry LB, de Almeida FP, de Freitas Couto S, Jesse CR, Prigol M. Chrysin reverses the depressive-like behavior induced by hypothyroidism in female mice by regulating hippocampal serotonin and dopamine. Eur J Pharmacol 2018; 822:78-84. [DOI: 10.1016/j.ejphar.2018.01.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/08/2018] [Accepted: 01/15/2018] [Indexed: 12/29/2022]
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Fanibunda SE, Desouza LA, Kapoor R, Vaidya RA, Vaidya VA. Thyroid Hormone Regulation of Adult Neurogenesis. VITAMINS AND HORMONES 2018; 106:211-251. [DOI: 10.1016/bs.vh.2017.04.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Talaei A, Rafee N, Rafei F, Chehrei A. TSH cut off point based on depression in hypothyroid patients. BMC Psychiatry 2017; 17:327. [PMID: 28882111 PMCID: PMC5590144 DOI: 10.1186/s12888-017-1478-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 08/22/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The prevalence of depressive symptoms in hypothyroidism is high. Considering that hypothyroidism and depression share some clinical features, some researchers use the "brain hypothyroidism" hypothesis to explain the pathogenesis of depression. We aimed to detect a new TSH cut-off value in hypothyroidism based on depression symptoms. METHODS A cross-sectional study was conducted on hypothyroid patients referred to endocrine clinics. Individuals who had developed euthyroid state under treatment with levothyroxine with TSH levels of 0.5-5 MIU/L with no need for dosage change were included in the study. After comprehensive history taking, laboratory tests including TSH, T4 and T3 were performed. Beck depression questionnaire was completed for all patients by trained interviewers. TSH cut-off values based on depression was determined by Roc Curve analysis. RESULTS The participants were 174 hypothyroid patients (Female; 116: 66.7%, Male; 58: 33.3%) with mean age 45.5 ± 11.7 (19-68) years old. Based on Beck depression test, scores less than 10 was considered healthy and more than 10 were considered depressed. According to Roc curve analysis, the optimal cut- off value of TSH was 2.5 MIU/L with 89.66% sensitivity. The optimal TSH cut- off based on severe depression was 4 MIU/L. CONCLUSION The present study suggests that a clinically helpful TSH cut-off value for hypothyroidism should be based on associated symptoms, not just in population studies. Based on the assessment of depression, our study concludes that a TSH cutofff value of 2.5 MIU/L is optimal.
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Affiliation(s)
- A Talaei
- Department of Internal Medicine, School of Medicine, Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran. .,Amiralmomenin Hospital, Arak, Iran.
| | - N Rafee
- 0000 0001 1218 604Xgrid.468130.8Department of Internal Medicine, School of Medicine, Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - F Rafei
- 0000 0001 1218 604Xgrid.468130.8Department of Internal Medicine, School of Medicine, Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - A Chehrei
- 0000 0001 1218 604Xgrid.468130.8Department of Internal Medicine, School of Medicine, Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
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Rhee CM, Chen Y, You AS, Brunelli SM, Kovesdy CP, Budoff MJ, Brent GA, Kalantar-Zadeh K, Nguyen DV. Thyroid Status, Quality of Life, and Mental Health in Patients on Hemodialysis. Clin J Am Soc Nephrol 2017; 12:1274-1283. [PMID: 28705886 PMCID: PMC5544520 DOI: 10.2215/cjn.13211216] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 04/17/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVES In the general population, there is increasing recognition of the effect of thyroid function on patient-centered outcomes, including health-related quality of life and depression. Although hypothyroidism is highly prevalent in hemodialysis patients, it is unknown whether thyroid status is a risk factor for impaired health-related quality of life or mental health in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We examined the association of thyroid status, defined by serum thyrotropin, with health-related quality of life and depressive symptoms over time in a prospective cohort of 450 patients on hemodialysis from 17 outpatient dialysis facilities from May of 2013 to May of 2015 who underwent protocolized thyrotropin testing, Short-Form 36 surveys, and Beck Depression Inventory-II questionnaires every 6 months. We examined the association of baseline and time-dependent thyrotropin categorized as tertiles and continuous variables with eight Short-Form 36 domains and Beck Depression Inventory-II scores using expanded case mix plus laboratory adjusted linear mixed effects models. RESULTS In categorical analyses, the highest baseline thyrotropin tertile was associated with a five-point lower Short-Form 36 domain score for energy/fatigue (P=0.04); the highest time-dependent tertile was associated with a five-point lower physical function score (P=0.03; reference: lowest tertile). In continuous analyses, higher baseline serum thyrotropin levels (+Δ1 mIU/L) were associated with lower role limitations due to physical health (β=-1.3; P=0.04), energy/fatigue (β=-0.8; P=0.03), and pain scores (β=-1.4; P=0.002), equivalent to five-, three-, and five-point lower scores, respectively, for every 1-SD higher thyrotropin. Higher time-dependent thyrotropin levels were associated with lower role limitations due to physical health scores (β=-1.0; P=0.03), equivalent to a three-point decline for every 1-SD higher thyrotropin. Baseline and time-dependent thyrotropin were not associated with Beck Depression Inventory-II scores. CONCLUSIONS In patients on hemodialysis, higher serum thyrotropin levels are associated with impaired health-related quality of life across energy/fatigue, physical function, and pain domains. Studies are needed to determine if thyroid-modulating therapy improves the health-related quality of life of hemodialysis patients with thyroid dysfunction.
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Affiliation(s)
| | - Yanjun Chen
- Institute for Clinical and Translational Science, University of California, Irvine, California
| | - Amy S. You
- Division of Nephrology and Hypertension and
| | | | - Csaba P. Kovesdy
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Gregory A. Brent
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; and
- Departments of Medicine and
- Physiology, David Geffen School of Medicine at the University of California, Los Angeles, California
| | | | - Danh V. Nguyen
- Department of Medicine, University of California Irvine, Orange, California
- Institute for Clinical and Translational Science, University of California, Irvine, California
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