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Ahmed SM, Alzubide AA, Alhozali AM, Mal TW, Fakeeh AS, Aldurayhim IM, Alghamdi AK, Alzahrani NA. Frequency and Determinants of Depression in Hypothyroidism Patients at a Tertiary Care Hospital in the Western Region of Saudi Arabia. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:259-265. [PMID: 39055073 PMCID: PMC11268540 DOI: 10.4103/sjmms.sjmms_261_23] [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] [Received: 06/03/2023] [Revised: 11/14/2023] [Accepted: 03/26/2024] [Indexed: 07/27/2024]
Abstract
Background Several studies have reported a strong association between depression and hypothyroidism, including from several regions of Saudi Arabia. However, studies on the frequency of depression among patients with hypothyroidism from the Western region of Saudi Arabia is limited. Objectives To determine the frequency and risk factors of depression among patients with hypothyroidism in the Western Region of Saudi Arabia. Materials and Methods This cross-sectional study was conducted at a tertiary care hospital in Jeddah, Saudi Arabia, and included adult patients diagnosed with hypothyroidism. After contacting the patients through phone calls and obtaining their consent, a questionnaire weblink was sent. The first part of the questionnaire elicited details regarding demographics and history of hypothyroidism, while the second part comprised the Arabic version of the Patient Health Questionnaire-9 to evaluate depression. Results A total of 100 patients completed the survey, of which 80% were found to have depression (mild: 35%, moderate: 26%, moderate to severe: 12, severe: 7%). There was no significant association between depression and gender, age group, employment status, and marital status. In the bivariate analysis, a significant association was found between depression and reporting fatigue (P < 0.001), constipation (P < 0.001), hair loss (P = 0.002), cold intolerance (P = 0.014), dry skin (P = 0.028), memory problems (P = 0.029), and menorrhagia (P = 0.037). However, in the multivariate analysis, only reporting fatigue was found to be significantly associated with depression (P = 0.040; OR = 15.215). Conclusion This study found that the prevalence of depression was very high among patients with hypothyroidism in the Western region of Saudi Arabia, and that fatigue is an independent risk factor of depression.
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Affiliation(s)
- Samraa M. Ahmed
- Department of Medicine, Psychiatry Division, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | - Amani M. Alhozali
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Turky W. Mal
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amro S. Fakeeh
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Bablis P, Day RR, Bablis S, Pollard H. Treatment of Hypothyroidism and Stress Using Neuro-Emotional Technique (NET): A Case Study. Cureus 2024; 16:e58231. [PMID: 38745794 PMCID: PMC11092426 DOI: 10.7759/cureus.58231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/16/2024] Open
Abstract
Hypothyroidism is generally considered an autoimmune condition, and typical medical management involves taking levothyroxine (synthetic thyroid hormone) for life. This case report details the results of a mind-body intervention (MBI) called the Neuro-Emotional Technique (NET) used to treat a 28-year-old Caucasian female presenting with symptoms and bloodwork markers associated with two years of hypothyroidism and a long history of stress. The patient's medical doctor provided a diagnosis of hypothyroidism after blood tests showed that thyroid-stimulating hormone (TSH) levels were high at 6.87 mIU/L (where the acceptable range is 0.40-3.50 mIU/L) and free T4 (FT4) levels were low at 8.6 pmol/L (where the acceptable range is 9.0-19.0 pmol/L). Psychometric tests were completed at baseline and after 12 weeks of treatment to evaluate changes in mental health and emotional well-being. The Adverse Childhood Experiences Questionnaire (ACE-Q) revealed a high degree of childhood trauma that may have predisposed to the underlying autoimmune thyroid dysfunction. At the conclusion of the treatment period, serum thyroid-stimulating hormone (TSH) and free T4 were within normal ranges and psychometric indicators normalized. We hypothesize that these changes may be due to the stress-reducing mechanism of NET and outline possible mechanisms via the Psycho-Immune-Neuroendocrine (PINE) network. The PINE network model asserts that chronic stress acts as a potential driver of pathophysiology that can lead to one or more medical and mental health conditions. While further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, the results of this case suggest that it may be pertinent to consider co-management of subclinical hypothyroidism with a relatively quick and cost-effective MBI such as NET.
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Affiliation(s)
- Peter Bablis
- Department of Maternal and Child Health and Precision Medicine, University Research Institute, Athens, GRC
- Department of Integrative and Complementary Medicine, Universal Health, Sydney, AUS
| | - Ryan R Day
- Department of Chiropractic, Universal Health, Sydney, AUS
| | - Sophia Bablis
- Department of Psychology, Universal Health, Sydney, AUS
| | - Henry Pollard
- Faculty of Health Sciences, Durban University of Technology, Durban, ZAF
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Sabatino L, Lapi D, Del Seppia C. Factors and Mechanisms of Thyroid Hormone Activity in the Brain: Possible Role in Recovery and Protection. Biomolecules 2024; 14:198. [PMID: 38397435 PMCID: PMC10886502 DOI: 10.3390/biom14020198] [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] [Received: 12/20/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Thyroid hormones (THs) are essential in normal brain development, and cognitive and emotional functions. THs act through a cascade of events including uptake by the target cells by specific cell membrane transporters, activation or inactivation by deiodinase enzymes, and interaction with nuclear thyroid hormone receptors. Several thyroid responsive genes have been described in the developing and in the adult brain and many studies have demonstrated a systemic or local reduction in TH availability in neurologic disease and after brain injury. In this review, the main factors and mechanisms associated with the THs in the normal and damaged brain will be evaluated in different regions and cellular contexts. Furthermore, the most common animal models used to study the role of THs in brain damage and cognitive impairment will be described and the use of THs as a potential recovery strategy from neuropathological conditions will be evaluated. Finally, particular attention will be given to the link observed between TH alterations and increased risk of Alzheimer's Disease (AD), the most prevalent neurodegenerative and dementing condition worldwide.
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Affiliation(s)
- Laura Sabatino
- Institute of Clinical Physiology, National Council of Research, Via Moruzzi 1, 56124 Pisa, Italy;
| | - Dominga Lapi
- Department of Biology, University of Pisa, 56127 Pisa, Italy;
| | - Cristina Del Seppia
- Institute of Clinical Physiology, National Council of Research, Via Moruzzi 1, 56124 Pisa, Italy;
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Liang H, Wang JM, Wei XQ, Su XQ, Zhang BX. Thyroid function, renal function, and depression: an association study. Front Psychiatry 2023; 14:1182657. [PMID: 38179254 PMCID: PMC10765600 DOI: 10.3389/fpsyt.2023.1182657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/15/2023] [Indexed: 01/06/2024] Open
Abstract
Objective To investigate the correlations between thyroid function, renal function, and depression. Methods Clinical data of 67 patients with Major depressive disorder (MDD) and 36 healthy control subjects between 2018 and 2021 were collected to compare thyroid and renal function. Thyroid and renal functions of depressed patients were then correlated with the Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Rating Scale (HAMA).Spearman correlation analysis was used to find the correlation between renal function, thyroid function, and depression. A logistic regression was performed to find significant predictors of depression. Results Triiodothyronine protamine (T3), thyroxine (T4), free triiodothyronine protamine (FT3), uric acid, sodium, and anion gap were lower in the MDD group than in the control group (p < 0.05). Correlation analysis of thyroid function, renal function, and factor terms of HAMD in the MDD group suggested that diurnal variation, hopelessness, and depression level were positively correlated with thyrotropin (TSH) (p < 0.05). Cognitive disturbance, retardation, and depression level were negatively correlated with creatinine (p < 0.05). Diurnal variation was negatively correlated with sodium ion (p < 0.01); hopelessness and depression level were positively correlated with chloride ion (p < 0.05); diurnal variation, retardation, and depression level were negatively correlated with anion gap (p < 0.05). Diurnal variation (p < 0.01) and retardation (p < 0.05) were negatively correlated with osmolality. Cognitive disturbance and depression level were positively correlated with estimated glomerular filtration rate (eGFR) (p < 0.05). In the MDD group, correlation analysis of thyroid function, renal function, and HAMA factor terms suggested that the total HAMA score and anxiety level were positively correlated with chloride ion (p < 0.05); psychic anxiety, total HAMA score, and anxiety level were negatively correlated with anion gap (p < 0.05). Furthermore, a low level of anion gap was an independent risk factor for depression and anxiety levels (p < 0.05). Conclusion Low thyroid function and reduced waste metabolized by the kidneys in patients with MDD suggest a low intake and low metabolism in depressed patients. In addition, subtle fluctuations in the anion gap in depressed patients were strongly correlated with the degree of depression and anxiety.
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Affiliation(s)
- Hai Liang
- Department of Neurology, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Neurology, The Third Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jin-min Wang
- Department of Neurology, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiao-qian Wei
- Department of Integrative Medicine and Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Xiao-qin Su
- Department of Neurology, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Bi-xia Zhang
- Department of Neurology, Minhou Country Hospital, Fuzhou, China
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Sun QM, Zhang S, Xu YH, Ma J, Zhang YT, Zhang XY. Depression severity partially mediates the association between thyroid function and psychotic symptoms in first-episode, drug-naive major depressive disorder patients with comorbid anxiety at different ages of onset. J Affect Disord 2023; 339:342-347. [PMID: 37437726 DOI: 10.1016/j.jad.2023.07.015] [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: 11/21/2022] [Revised: 06/06/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Anxiety and psychotic symptoms are common in patients with major depressive disorder (MDD), with a strong association with thyroid function. Age of onset contributes to the heterogeneity of MDD patients. This study aimed to assess the prevalence of psychotic symptoms in MDD patients with comorbid anxiety and to explore the relationship between thyroid function and psychotic symptoms by ages of onset. METHODS A total of 894 first-episode, drug-naïve Chinese Han MDD patients with comorbid anxiety were recruited. Thyroid function and psychometric measures including Hamilton Anxiety Scale, Hamilton Depression Scale, and Positive and Negative Syndrome Scale were evaluated. Patients were divided into early adulthood onset (EAO, < 45 years old) and mid-adulthood onset (MAO, ≥ 45 years old) groups. RESULTS The MAO subgroup had a higher prevalence of psychotic symptoms compared to EAO subgroup. TSH and TPOAb levels were positively correlated with psychotic symptoms severity, with a more pronounced effect in MAO subgroup. Furthermore, MDD severity partially mediated the effects of TPOAb and TSH levels on psychotic symptoms in both subgroups. LIMITATIONS A causal relationship could not be demonstrated with this cross-sectional study, and the results should be limited to first-episode, drug-naïve MDD patients without considering more potential confounders. Moreover, the male-to-female ratio imbalance is present. CONCLUSIONS Our results indicated that age of onset moderated the association between thyroid function and psychotic symptom, and depression severity partially mediated the effects of thyroid function on psychotic symptoms, suggesting thyroid function may serve as a biomarker of psychotic symptoms in MDD patients with anxiety.
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Affiliation(s)
- Qi-Meng Sun
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China
| | - Sen Zhang
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China
| | - Ya-Hui Xu
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | | | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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Rutigliano G, Bertolini A, Grittani N, Frascarelli S, Carnicelli V, Ippolito C, Moscato S, Mattii L, Kusmic C, Saba A, Origlia N, Zucchi R. Effect of Combined Levothyroxine (L-T 4) and 3-Iodothyronamine (T 1AM) Supplementation on Memory and Adult Hippocampal Neurogenesis in a Mouse Model of Hypothyroidism. Int J Mol Sci 2023; 24:13845. [PMID: 37762153 PMCID: PMC10530993 DOI: 10.3390/ijms241813845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Mood alterations, anxiety, and cognitive impairments associated with adult-onset hypothyroidism often persist despite replacement treatment. In rodent models of hypothyroidism, replacement does not bring 3-iodothyronamine (T1AM) brain levels back to normal. T1AM is a thyroid hormone derivative with cognitive effects. Using a pharmacological hypothyroid mouse model, we investigated whether augmenting levothyroxine (L-T4) with T1AM improves behavioural correlates of depression, anxiety, and memory and has an effect on hippocampal neurogenesis. Hypothyroid mice showed impaired performance in the novel object recognition test as compared to euthyroid mice (discrimination index (DI): 0.02 ± 0.09 vs. 0.29 ± 0.06; t = 2.515, p = 0.02). L-T4 and L-T4+T1AM rescued memory (DI: 0.27 ± 0.08 and 0.34 ± 0.08, respectively), while T1AM had no effect (DI: -0.01 ± 0.10). Hypothyroidism reduced the number of neuroprogenitors in hippocampal neurogenic niches by 20%. L-T4 rescued the number of neuroprogenitors (mean diff = 106.9 ± 21.40, t = 4.99, pcorr = 0.003), while L-T4+T1AM produced a 30.61% rebound relative to euthyroid state (mean diff = 141.6 ± 31.91, t = 4.44, pcorr = 0.004). We performed qPCR analysis of 88 genes involved in neurotrophic signalling pathways and found an effect of treatment on the expression of Ngf, Kdr, Kit, L1cam, Ntf3, Mapk3, and Neurog2. Our data confirm that L-T4 is necessary and sufficient for recovering memory and hippocampal neurogenesis deficits associated with hypothyroidism, while we found no evidence to support the role of non-canonical TH signalling.
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Affiliation(s)
- Grazia Rutigliano
- Institute of Clinical Science, Imperial College London, London SW7 2AZ, UK
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
- CNR Institute of Clinical Physiology, 56124 Pisa, Italy;
| | - Andrea Bertolini
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
| | - Nicoletta Grittani
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
| | - Sabina Frascarelli
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
| | - Vittoria Carnicelli
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
| | - Chiara Ippolito
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.I.); (S.M.); (L.M.)
| | - Stefania Moscato
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.I.); (S.M.); (L.M.)
| | - Letizia Mattii
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.I.); (S.M.); (L.M.)
| | - Claudia Kusmic
- CNR Institute of Clinical Physiology, 56124 Pisa, Italy;
| | - Alessandro Saba
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
| | | | - Riccardo Zucchi
- Department of Pathology, University of Pisa, 56126 Pisa, Italy; (A.B.); (N.G.); (S.F.); (V.C.); (A.S.); (R.Z.)
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Dai W, Liu J, Xie H, Teng Z, Luo W, Yuan H, Chen J, Liu M, Zhang X. Association between subclinical hypothyroidism and psychotic features in Chinese young adults with first-episode and untreated major depressive disorder. J Affect Disord 2023; 333:209-215. [PMID: 37086799 DOI: 10.1016/j.jad.2023.04.067] [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: 12/03/2022] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Thyroid dysfunction is often reported in patients with major depressive disorder (MDD) and may be associated with depression severity and psychotic symptoms. We included young adults with first-episode and untreated MDD to avoid the effect of age and disease duration on thyroid dysfunction and psychotic symptoms. METHODS 481 young patients with MDD (aged 18-24 years) were recruited. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale and Global Impression of Severity Scale (CGIS) were used to assess depression, anxiety, psychotic symptoms and disease severity, respectively. RESULTS The prevalence rate of subclinical hypothyroidism (SCH) and thyroid antibody positivity was 56.76 % (273/481) and 26.61 % (128/481) in young MDD, respectively. A higher proportion of MDD patients with SCH displayed psychotic features (14.3 % vs. 5.3 %, OR = 2.985, p = 0.001). TSH was a risk factor for psychotic symptoms in MDD patient with SCH (B = 0.136, p = 0.017, OR = 1.384), with an AUC of 0.709, indicating acceptable discrimination. Multivariate regression analysis also showed that TSH was also independently associated with PANSS positive score (B = 0.339, t = 2.019, p = 0.045). LIMITATION This cross-sectional study design did not demonstrate a causal relationship. Relying solely on the PANSS positive subscale as psychotic symptoms may cause bias. CONCLUSIONS Our findings suggest that SCH is common in young patients with first-episode and untreated MDD. MDD patients with higher TSH levels may suffer from more psychotic symptoms. Regular screening of serum thyroid hormones is necessary in patients with MDD.
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Affiliation(s)
- Wenyu Dai
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jieyu Liu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Department of Ultrasound Diagnostic, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haiqing Xie
- Department of Ultrasound Diagnostic, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wenbo Luo
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Yuan
- Department of Stomatology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Minghui Liu
- Department of Ultrasound Diagnostic, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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AlAwaji MI, Alhamwy RH. The Impact of Hypothyroidism on the Quality of Life of Adults in Riyadh, Saudi Arabia. Cureus 2023; 15:e37636. [PMID: 37200671 PMCID: PMC10187085 DOI: 10.7759/cureus.37636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
Background and objective Hypothyroidism is extremely common and associated with far-reaching health consequences. The negative effects of hypothyroidism on patients' quality of life (QoL) are well-documented. It is said to be common in the countries of the Arabian Gulf, although it is often misdiagnosed and treated in an inconsistent manner. Hence, understanding how an illness like this affects a patient's life might help us enhance their QoL and get us closer to the healthcare transformation goals of Saudi Arabia's Vision 2030. Methodology This cross-sectional study was conducted in Riyadh, Saudi Arabia, between June 2022 and February 2023. A convenience non-probability sampling method was used. The WHO Quality of Life (WHOQOL)-BREF questionnaire in Arabic was used to compile the data. Data were collected using a standardized form, refined using Google Forms, and then documented in an Excel spreadsheet. The descriptive statistics were shown as means and standard deviations (SD). To assess the numerical data, a t-test was used, while the chi-square test was employed to examine the relationship between the qualitative factors. Results A total of 394 adults from the general population with hypothyroidism were surveyed, including 105 men and 289 women. Of them, 151 (38.3%) patients had not sought therapy for their hypothyroidism, while 243 (61.7%) patients had. When asked about the QoL, a significant segment (37.6%) of patients reported that it was high, and 29.7% reported being totally satisfied with their health. The WHOQOL-BREF domain scores revealed that environmental health had the highest value (24.04 ±4.62), followed by physical health (22.24 ±3.23), and then psychological health (18.08 ±2.82), and the lowest scores were reported for the rate of QoL and satisfaction with health (2.64 ±1.36 and 2.80 ±1.68), respectively. Each domain of the WHOQOL-BREF had its own set of variables that differed from one another in a statistically significant manner (p<0.001). Conclusions Based on our findings, we recommend expert physician monitoring and implementing educational programs as well as placing a greater emphasis on patients' QoL in the management of hypothyroidism.
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Affiliation(s)
- May I AlAwaji
- Family Medicine, King Fahad Medical City, Riyadh, SAU
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Stern M, Finch A, Haskard-Zolnierek KB, Howard K, Deason RG. Cognitive decline in mid-life: Changes in memory and cognition related to hypothyroidism. J Health Psychol 2023; 28:388-401. [PMID: 35811484 DOI: 10.1177/13591053221107745] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study assessed specific cognitive impairments within a primarily female, hypothyroid population, while controlling for factors that commonly contribute to cognitive decline. Participants (N = 739) included 461 individuals with hypothyroidism. This study involved an online survey assessing several aspects of memory and cognition. Those with hypothyroidism generally scored worse on self-assessments of memory, higher perceived stress, high rates of depression and anxiety, greater fatigue, poorer concentration, and less motivation. A Receiver Operating Characteristic curve indicated that the cognitive questionnaires are successful at classifying hypothyroidism and a mediation analysis showed fatigue is a mediating symptom of these cognitive outcomes.
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Affiliation(s)
- Mark Stern
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Alyse Finch
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | | | - Krista Howard
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Rebecca G Deason
- Department of Psychology, Texas State University, San Marcos, TX, USA
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Wu S, Wang H, Zhou Y, Xia X, Yue Y, Wu Y, Peng R, Yang R, Li R, Yuan N, Li Z, Zhao X, Yin M, Du X, Zhang X. Clinical correlates of autoimmune thyroiditis and non-autoimmune hypothyroidism in treatment-naïve patients with major depressive disorders. J Affect Disord 2023; 323:755-761. [PMID: 36529413 DOI: 10.1016/j.jad.2022.12.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/07/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Thyroid autoimmunity is a potentially critical factor that is often neglected in the association between subclinical hypothyroidism (SCH) and depressive disorders. This study aimed to investigate the clinical correlates of autoimmune thyroiditis (AIT) and non-autoimmune hypothyroidism (NAIH) in treatment-naïve patients with major depressive disorder (MDD). METHOD Using a cross-sectional design, we recruited a total of 1718 outpatients with treatment-naïve MDD. Demographic and relevant clinical information including duration of MDD, severity of depression and anxiety, psychotic symptoms, suicide attempts, thyroid function parameters, etc. were collected. According to thyroid function parameters, patients were classified as AIT, NAIH, latent Hashimoto's thyroiditis (LH) and euthyroidism (ET). RESULTS Patients with SCH (including AIT and NAIH) had older age at onset, and were more likely to have psychotic symptoms compared to those with ET. Multiple linear regression analysis showed that SCH was associated with duration of MDD and HAMD scores. Logistic regression analysis showed that the odds of having more severe anxiety and metabolic syndrome were greater among patients with SCH compared to those with ET. The odds of having suicide attempts were greater among patients with AIT than among those with ET. LIMITATION Because of the cross-sectional design of this study, we were unable to sort out causality between MDD and SCH. CONCLUSION Our findings suggested that AIT and NAIH were associated with duration of MDD, HAMD scores, severity of anxiety, and metabolic syndrome. However, only AIT in SCH was associated with suicide attempts.
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Affiliation(s)
- Siqi Wu
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China; Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Haitao Wang
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Yue Zhou
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China; Xuzhou Medical University, Xuzhou, China
| | - Xingzhi Xia
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China; Xuzhou Medical University, Xuzhou, China
| | - Yan Yue
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China; Medical College of Soochow University, Suzhou, China
| | - Yuxuan Wu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China; Medical College of Soochow University, Suzhou, China
| | - Ruijie Peng
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China; Medical College of Soochow University, Suzhou, China
| | - Ruchang Yang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China; Medical College of Soochow University, Suzhou, China
| | - Ronghua Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Nian Yuan
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xueli Zhao
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ming Yin
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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11
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Redei EE, Udell ME, Solberg Woods LC, Chen H. The Wistar Kyoto Rat: A Model of Depression Traits. Curr Neuropharmacol 2023; 21:1884-1905. [PMID: 36453495 PMCID: PMC10514523 DOI: 10.2174/1570159x21666221129120902] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/19/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
There is an ongoing debate about the value of animal research in psychiatry with valid lines of reasoning stating the limits of individual animal models compared to human psychiatric illnesses. Human depression is not a homogenous disorder; therefore, one cannot expect a single animal model to reflect depression heterogeneity. This limited review presents arguments that the Wistar Kyoto (WKY) rats show intrinsic depression traits. The phenotypes of WKY do not completely mirror those of human depression but clearly indicate characteristics that are common with it. WKYs present despair- like behavior, passive coping with stress, comorbid anxiety, and enhanced drug use compared to other routinely used inbred or outbred strains of rats. The commonly used tests identifying these phenotypes reflect exploratory, escape-oriented, and withdrawal-like behaviors. The WKYs consistently choose withdrawal or avoidance in novel environments and freezing behaviors in response to a challenge in these tests. The physiological response to a stressful environment is exaggerated in WKYs. Selective breeding generated two WKY substrains that are nearly isogenic but show clear behavioral differences, including that of depression-like behavior. WKY and its substrains may share characteristics of subgroups of depressed individuals with social withdrawal, low energy, weight loss, sleep disturbances, and specific cognitive dysfunction. The genomes of the WKY and WKY substrains contain variations that impact the function of many genes identified in recent human genetic studies of depression. Thus, these strains of rats share characteristics of human depression at both phenotypic and genetic levels, making them a model of depression traits.
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Affiliation(s)
- Eva E. Redei
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mallory E. Udell
- Department of Pharmacology, Addiction Science, and Toxicology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Leah C. Solberg Woods
- Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hao Chen
- Department of Pharmacology, Addiction Science, and Toxicology, University of Tennessee Health Science Center, Memphis, TN, USA
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12
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Evolutionarily conserved gene expression patterns for affective disorders revealed using cross-species brain transcriptomic analyses in humans, rats and zebrafish. Sci Rep 2022; 12:20836. [PMID: 36460699 PMCID: PMC9718822 DOI: 10.1038/s41598-022-22688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 12/03/2022] Open
Abstract
Widespread, debilitating and often treatment-resistant, depression and other stress-related neuropsychiatric disorders represent an urgent unmet biomedical and societal problem. Although animal models of these disorders are commonly used to study stress pathogenesis, they are often difficult to translate across species into valuable and meaningful clinically relevant data. To address this problem, here we utilized several cross-species/cross-taxon approaches to identify potential evolutionarily conserved differentially expressed genes and their sets. We also assessed enrichment of these genes for transcription factors DNA-binding sites down- and up- stream from their genetic sequences. For this, we compared our own RNA-seq brain transcriptomic data obtained from chronically stressed rats and zebrafish with publicly available human transcriptomic data for patients with major depression and their respective healthy control groups. Utilizing these data from the three species, we next analyzed their differential gene expression, gene set enrichment and protein-protein interaction networks, combined with validated tools for data pooling. This approach allowed us to identify several key brain proteins (GRIA1, DLG1, CDH1, THRB, PLCG2, NGEF, IKZF1 and FEZF2) as promising, evolutionarily conserved and shared affective 'hub' protein targets, as well as to propose a novel gene set that may be used to further study affective pathogenesis. Overall, these approaches may advance cross-species brain transcriptomic analyses, and call for further cross-species studies into putative shared molecular mechanisms of affective pathogenesis.
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13
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Wang S, Su ML, Zhang Y, Wu HM, Zou ZH, Zhang W, Deng F, Zhao Y. Role of N-methyl-d-aspartate receptors in anxiety disorder with thyroid lesions. J Psychosom Res 2022; 161:110998. [PMID: 35964359 DOI: 10.1016/j.jpsychores.2022.110998] [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: 01/09/2022] [Revised: 07/23/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Patients with anxiety disorder (AD) often have structural and functional abnormalities of the thyroid gland, but their specific causes remain unclear. N-methyl- d-aspartate receptors (NMDARs) play an important role in many psychosomatic diseases and tumorigenesis, but there are few reports on the role of NMDARs in AD with thyroid lesions, especially thyroid nodules (TNs). METHODS A cross-sectional study was conducted on patients admitted to the hospital with AD (n = 71) as the main diagnosis from April to October 2021. Meanwhile, patients with TNs with no AD (NAD-TN group, n = 20) and healthy subjects (HS group, n = 37) with matched age, sex, and education were randomly collected as controls. Patients with AD were sub-grouped into the AD with TNs (AD-TN group, n = 41) and the AD with no TNs (AD-NTN group, n = 30). The thyroid ultrasound reports, Hamilton Anxiety Scale (HAMA) scores, and the expression of NMDARs and their subunits (NR1, NR2A, and NR2B) and hypothalamic-pituitary-thyroid (HPT) axis-related hormones were analyzed in all subjects. Some patients with TNs underwent surgery and postoperative pathological examination. RESULTS Patients with AD showed a lower level of free triiodothyronine (FT3) and higher levels of thyrotropin-releasing hormone (TRH) and NMDARs and their subunits compared to the healthy controls. The expression of the NR2A subunit was higher in the AD-TN group than that in other three groups (AD-NTN, NAD-TN, and HS groups, F = 13.650, p < 0.001). Regression analysis showed that the level of NMDARs was positively correlated with the HAMA scores (B = 1.622, p = 0.029) and the maximum diameter of TNs (B = 3.836, p = 0.005). Immunohistochemical results showed that the NR2A subunit was widely expressed in multinodular goiter (MNG) and papillary thyroid carcinoma (PTC) tissues, while the expression of the NR2B subunit was lower in PTC adjacent and MNG tissues and almost absent in PTC tissues. CONCLUSION In a sample of mostly women hospitalized with generalized anxiety disorder (GAD) or panic disorder, abnormal expression of NMDARs is closely related to AD with thyroid lesions, NMDAR subunits may have various activities and exert diverse effects in TNs, and the NR2A subunit may be an important regulator in AD with TNs.
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Affiliation(s)
- Song Wang
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mei-Lan Su
- Department of Psychosomatic Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Yan Zhang
- Department of Psychosomatic Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Hong-Mei Wu
- Department of Psychosomatic Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Zhong-Hui Zou
- Department of Stomach/Thyroid/Vascular Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Wei Zhang
- Department of Stomach/Thyroid/Vascular Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Feng Deng
- Department of Stomach/Thyroid/Vascular Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Yu Zhao
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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14
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Ghamri R, Babaker R, Ezzat S, Alsaedi H, Alkhamisi M, Arbaein R, Alyahya R, Fayraq S, Alamri S. Assessment of Quality of Life Among Patients With Primary Hypothyroidism: A Case-Control Study. Cureus 2022; 14:e29947. [PMID: 36348860 PMCID: PMC9635404 DOI: 10.7759/cureus.29947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 05/29/2023] Open
Abstract
Introduction Hypothyroidism is a globally prevalent condition with a huge impact on health. It has been demonstrated that hypothyroidism is associated with negative health outcomes that have a significant impact on quality of life. The aim of this study is to assess the relative significance of various parts of quality of life satisfaction in adult patients with hypothyroidism. This study has never been done in Saudi Arabia. No previous research was conducted in our region to highlight the quality of life of these patients. From this, it is very important to acknowledge the impact of hypothyroidism on quality of life, to help improve their lives and reduce the burden of the disease. Method This is a case-control study conducted on patients with hypothyroidism presented to the family medicine clinic at King Abdulaziz University Hospital. The participants were divided into two groups: patients with primary hypothyroidism (cases) and euthyroid subjects of the same age without chronic illnesses (control group). We used the Short Form-12 questionnaire (SF-12) and a sociodemographic questionnaire as a tool to assess the quality of life. Results Compared to healthy euthyroid controls, patients with hypothyroidism had a significantly reduced quality of life regarding their physical (p<0.001) aspect, with mental health not being affected. Smoking, female gender, and BMI showed significant associations with their mental health status (p=0.021, p=0.001, and p=0.045) respectively. Conclusions Regarding the results of the current study, there is a reduced level of physical health in patients with hypothyroidism than in healthy controls, which adversely affects their QoL. Smoking, gender, and BMI were associated with lower mental health among patients with hypothyroidism, which adversely affected their quality of life. Health practices should include assessment of the quality of life, monitoring by specialized physicians, and educational programs for these patients.
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Affiliation(s)
- Ranya Ghamri
- Family Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Salwan Ezzat
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Haya Alsaedi
- Medical School, King Abdulaziz University, Jeddah, SAU
| | | | - Ragad Arbaein
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Rahaf Alyahya
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Shahad Fayraq
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Sultan Alamri
- Family Medicine, King Abdulaziz University, Jeddah, SAU
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15
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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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16
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Kamyshna I, Kamyshnyi A. Transcription factors and regulators pathway-focused genes expression analysis in patients with different forms of thyroid pathology. Curr Pharm Biotechnol 2022; 23:1396-1404. [PMID: 35176984 DOI: 10.2174/1389201023666220217123454] [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: 09/03/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Autoimmune thyroiditis (AIT) is a T cell-mediated organ-specific disorder and transcription factors have a critical role in the regulation of immune responses, especially in the fate of T-helper cells. OBJECTIVE This study aims to investigate changes in the gene expression profile of transcription factors and regulators in patients with different forms of thyroid pathology Methods. We used the pathway-specific real-time PCR array (Neurotrophins and Receptors RT2 Profiler PCR Array, QIAGEN, Germany) to identify and verify transcription factors and regulators pathway-focused genes expression in peripheral white blood cells of patients with postoperative hypothyroidism, hypothyroidism as a result of AIT and AIT with elevated serum an anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (anti-TPO) antibodies. RESULTS It was shown that in patients with postoperative hypothyroidism FOS, NR1I2, STAT4, and TP53 significantly increased their expression whereas the expression of STAT1, STAT2, and STAT3 decreased. In patients with hypothyroidism as a result of AIT, we have found increased expression of NR1I2, STAT2, and STAT3. In contrast, the expression of STAT1 and TP53 decreased. FOS and STAT4 mRNAs did not change their expression. In patients with AIT and elevated serum anti-Tg and anti-TPO antibodies, the expression of FOS and NR1I2 reduced whereas the mRNA level of STAT3 increased. STAT1, STAT2, and STAT4 mRNAs did not change their expression. MYC did not change its expression in all groups of patients. CONCLUSIONS The results of this study demonstrate that autoimmune thyroiditis and hypothyroidism affect the mRNA-level expression of transcription factors and regulators genes in a gene-specific manner and that these changes to genes expression can be among the triggers of autoimmune inflammation progression in the thyroid gland.
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Affiliation(s)
- Iryna Kamyshna
- Department of Medical Rehabilitation, I. Horbachevsky Ternopil National Medical University, Majdan Voli 1, Ternopil, Ukraine
| | - Aleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Majdan Voli 1, Ternopil, Ukraine
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17
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Abdel-Wahab M, Okasha T, Shaheen M, Nasr M, Molokheya T, Omar AE, Rabie MA, Samy V, Hamed H, Ali M. Clinical Guidelines of the Egyptian Psychiatric Association for the Management of Treatment-Resistant Unipolar Depression in Egypt. Front Psychiatry 2022; 13:797150. [PMID: 35370819 PMCID: PMC8964405 DOI: 10.3389/fpsyt.2022.797150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a public health burden that creates a strain not only on individuals, but also on the economy. Treatment-resistant depression in the course of major depressive disorder represents a clinically challenging condition that is defined as insufficient response to two or more antidepressant trails with antidepressants of the same or different classes that were administered at adequate daily doses for at least 4 weeks. OBJECTIVE/HYPOTHESIS To develop a treatment guideline for Treatment Resistant Depression (TRD). METHODOLOGY Experts in the field gathered and reviewed the available evidence about the subject. Then, a series of meetings were held to create recommendations that can be utilized by Egyptian psychiatrists. RESULTS The guidelines provide recommendations in various clinical settings. It evaluates different situations, such as patients at risk of resistance, those with resistance and recommends strategies to resolve the clinical case. CONCLUSION The consensus guidelines will improve the outcomes of patients, as they provide recommendations across various domains that are of concern for the practicing psychiatrist.
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Affiliation(s)
- Momtaz Abdel-Wahab
- Department of Psychiatry, Kasr El-Aini Medical School, Cairo University, Giza, Egypt
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Medical School, Ain Shams University, Cairo, Egypt
| | - Mostafa Shaheen
- Department of Psychiatry, Kasr El-Aini Medical School, Cairo University, Cairo, Egypt
| | - Mohamed Nasr
- Department of Psychiatry, Kasr El-Aini Medical School, Cairo University, Cairo, Egypt
| | - Tarek Molokheya
- Department of Psychiatry, Alexandria Medical School, Alexandria University, Alexandria, Egypt
| | - Abd ElNasser Omar
- Department of Psychiatry, Ain Shams Medical School, Ain Shams University, Cairo, Egypt
| | - Menan A Rabie
- Department of Psychiatry, Ain Shams Medical School, Ain Shams University, Cairo, Egypt
| | - Victor Samy
- Department of Psychiatry, Banha Medical School, Banha University, Benha, Egypt
| | - Hany Hamed
- Department of Psychiatry, Beni-Suef Medical School, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed Ali
- Faculty of Pharmacy, German University of Cairo, Cairo, Egypt
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18
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Yang R, Du X, Li Z, Zhao X, Lyu X, Ye G, Lu X, Zhang G, Li C, Yue Y, Wu Y, Peng R, Zhou Y, Wang H, Wu S, Ganapathi PB, Wu HE, Zhang X. Association of Subclinical Hypothyroidism With Anxiety Symptom in Young First-Episode and Drug-Naïve Patients With Major Depressive Disorder. Front Psychiatry 2022; 13:920723. [PMID: 35815037 PMCID: PMC9263214 DOI: 10.3389/fpsyt.2022.920723] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUNDS Subclinical hypothyroidism (SCH) was reported to be associated with depression; however, its role in coexisting anxiety symptom in young patients with major depressive disorder (MDD) remains unclear. The objective of this study was to explore the relationship between SCH and anxiety symptom in young first-episode and drug-naïve (FEDN) MDD patients. METHODS A total of 520 outpatients diagnosed as FEDN MDD with SCH were recruited in this study. Their socio-demographic, clinical data and thyroid function parameters were collected. The Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Rating Scale (HAMD) were employed to measure the severity of anxiety symptom and depressive symptom, respectively. Based on the HAMA scores, patients who scored ≥ 25 were defined as anxious major depressive disorder (A-MDD) while others as non-anxious major depressive disorder (NA-MDD). RESULTS The prevalence rate of A-MDD was 15.8% in young FEDN MDD patients with comorbid SCH. Moreover, serum thyroid stimulating hormone (TSH) levels were significantly higher in patients with A-MDD compared with those with NA-MDD (p < 0.001). Multivariate binary logistic regression analysis indicated that A-MDD was associated with serum TSH levels with an odds ratio (OR) of 1.602. Serum TSH level of 6.17 mIU/L was the critical value to distinguish A-MDD and NA-MDD, with sensitivity of 0.805 and specificity of 0.539. There were no statistically significant differences between NA-MDD and A-MDD patients in terms of socio-demographic variables, serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidases antibody (TPOAb) and anti-thyroglobulin (TgAb) levels. CONCLUSIONS A-MDD patients presented higher serum TSH level. It is suggested that serum TSH level may be a potential biomarker for predicting moderate and severe anxiety symptoms in young FEDN MDD patients with SCH.
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Affiliation(s)
- Ruchang Yang
- Suzhou Medical College of Soochow University, Suzhou, China.,Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xueli Zhao
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaoli Lyu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Gang Ye
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xinchuan Lu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Guangya Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Chuanwei Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yan Yue
- Suzhou Medical College of Soochow University, Suzhou, China.,Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yuxuan Wu
- Suzhou Medical College of Soochow University, Suzhou, China.,Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ruijie Peng
- Suzhou Medical College of Soochow University, Suzhou, China.,Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yue Zhou
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.,Xuzhou Medical University, Xuzhou, China
| | - Haitao Wang
- School Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Siqi Wu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.,School Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Pallavi B Ganapathi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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19
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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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20
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Nerve impulse transmission pathway-focused genes expression analysis in patients with primary hypothyroidism and autoimmune thyroiditis. Endocr Regul 2021; 54:109-118. [PMID: 32597152 DOI: 10.2478/enr-2020-0013] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Thyroid hormones have important actions in the adult brain. They regulate genes expression in myelination, differentiation of neuronal and glial cells, and neuronal viability and function. METHODS We used the pathway-specific real-time PCR array (Neurotrophins and Receptors RT2 Profiler PCR Array, QIAGEN, Germany) to identify and verify nerve impulse transmission pathway-focused genes expression in peripheral white blood cells of patients with postoperative hypothyroidism, hypothyroidism as a result of autoimmune thyroiditis (AIT) and AIT with elevated serum an anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (anti-TPO) antibodies. RESULTS It was shown that patients with postoperative hypothyroidism and hypothyroidism resulting from AIT had significantly lower expression of BDNF and CBLN1. In patients with AIT with elevated serum anti-Tg and anti-TPO antibodies, the expression of GDNF was significantly down-regulated and the expression of PNOC was up-regulated. The expression levels of MEF2C and NTSR1 were decreased in the group of patients with postoperative hypothyroidism and AIT, correspondingly. CONCLUSIONS The results of this study demonstrate that AIT and hypothyroidism can affect the expression of mRNA nerve impulse transmission genes in gene specific manner and that these changes in gene expressions can be playing a role in the development of neurological complications associated with thyroid pathology. Detection of the transcriptional activity of nerve impulse transmission genes in peripheral white blood cells can be used as an important minimally invasive prognostic marker of the risk for developing neurological complications comorbid with thyroid pathology.
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21
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Polybrominated Diphenyl Ether Serum Concentrations and Depressive Symptomatology in Pregnant African American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073614. [PMID: 33807211 PMCID: PMC8037135 DOI: 10.3390/ijerph18073614] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 02/04/2023]
Abstract
(1) Polybrominated diphenyl ethers (PBDEs) were widely produced in the United States until 2004 but remain highly persistent in the environment. The potential for PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms is largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology. (2) Data were collected from 193 African American pregnant women at 8–14 weeks gestation. Serum PBDEs and depressive symptoms were analyzed and a mixture effect was calculated. (3) Urban pregnant African American women in the Southeastern United States had a high risk of depression (27%) compared to the National average. Increased levels of PBDEs were found. BDE-47 and -99 exposures are significantly associated with depressive symptomatology in the pregnant cohort. The weighted body burden estimate of the PBDE mixture was associated with a higher risk of mild to moderate depression using an Edinburgh Depression Scale cutoff score of ≥10 (OR = 2.93; CI 1.18, 7.82). (4) Since antenatal depression may worsen in postpartum, reducing PBDE exposure may have significant clinical implications.
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22
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Pankowski D, Wytrychiewicz-Pankowska K, Janowski K, Pisula E, Walicka M. The Role of Illness-Related Beliefs in Depressive, Anxiety, and Anger Symptoms: An On-line Survey in Women With Hypothyroidism. Front Psychiatry 2021; 12:614361. [PMID: 33967846 PMCID: PMC8100212 DOI: 10.3389/fpsyt.2021.614361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/26/2021] [Indexed: 11/13/2022] Open
Abstract
Hypothyroidism may affect 3-8.5% of the population and is a growing global health problem. Objective: The aim of the current study was to assess the relationships between cognitive representations of this illness and the severity of symptoms of depression, anxiety, and anger in women who suffer from hypothyroidism. Methods: The study used a cross-sectional design with on-line recruitment and measurements. A total of 354 women took part in the study and completed the following questionnaires: a 5-point self-rating scale that measures the three major symptoms of hypothyroidism, the Illness-Related Beliefs Questionnaire, the Hospital Anxiety and Depression Scale-Modified (HADS-M), and a clinical and sociodemographic data questionnaire. Results: The study found a relationship between the severity of emotional distress symptoms and illness-related beliefs. These beliefs were correlated with depressive symptoms, anxiety, and anger regardless of age, education, hormone levels or time since the diagnosis. In addition, the results of regression analyses, both hierarchical and stepwise, indicated that beliefs about the disease explained relatively high levels of the outcome variables (about 30% of the variance of depressive and anxiety symptoms and 16% of anger) as measured by HADS-M. Conclusions: Psychological factors seem to play an important role in the development of symptoms of depression, anxiety, and anger in patients with hypothyroidism. Psychosocial interventions targeting personal beliefs about the nature of the disease and its social aspects may be an effective way to reduce emotional distress symptoms.
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Affiliation(s)
- Daniel Pankowski
- Department of Psychology, University of Warsaw, Warsaw, Poland.,Department of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Kinga Wytrychiewicz-Pankowska
- Department of Psychology, University of Warsaw, Warsaw, Poland.,Department of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Konrad Janowski
- Department of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Ewa Pisula
- Department 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.,Department of Human Epigenetics, Mossakowski Medical Research Institute Polish Academy of Sciences, Warsaw, Poland
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23
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Zhou Y, Ma Y, Wu Q, Wang Q, Yang WFZ, Wang Y, Yang D, Luo Y, Tang K, Liu T, Wang D. Comparison of Thyroid Hormone Levels Between Patients With Major Depressive Disorder and Healthy Individuals in China. Front Psychiatry 2021; 12:750749. [PMID: 34721116 PMCID: PMC8551614 DOI: 10.3389/fpsyt.2021.750749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/08/2021] [Indexed: 12/28/2022] Open
Abstract
Abnormal thyroid function in major depressive disorder (MDD) has been studied extensively, but the results still remain inconsistent. In China, few large-scale studies have investigated the differences in the levels of thyroid hormones between patients with MDD and healthy controls (HCs). In this retrospective, cross-sectional study, 535 MDD patients and 998 HCs were included. We compared the levels of thyroid hormones (FT3, FT4, and TSH) between the two groups, as well as investigated the distribution of levels of thyroid hormones within and outside normal ranges. The results showed that all the three hormones were significantly lower in MDD patients than in HCs, which was also true in different gender and age subgroups. The proportion of subjects with levels of all the three hormones outside the normal range in the MDD group was higher than that in the HC group (all p < 0.05). However, no significant difference was found in clinical/subclinical hyperthyroidism or hypothyroidism between the two groups (p > 0.05). Our study showed that the levels of thyroid hormones were lower in MDD patients, suggesting that there was an association between abnormal thyroid function and depression. The higher rate of thyroid dysfunction in MDD patients indicated the importance of regular monitoring of thyroid function.
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Affiliation(s)
- Yanan Zhou
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China.,Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuejiao Ma
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, College of Arts and Sciences, Texas Tech University, Lubbock, TX, United States
| | - Yunfei Wang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Dong Yang
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Yinli Luo
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Kewei Tang
- Changqiao Compulsory Isolation and Rehabilitation Center, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Dongfang Wang
- Department of Psychiatry and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany
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24
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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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25
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Costache A, Riza AL, Popescu M, Dinca ME, Glavan DG, Vladu IM, Ioana M, Udristoiu I. 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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Affiliation(s)
| | - Anca-Lelia Riza
- University of Medicine and Pharmacy of Craiova, Romania
- Regional Center of Medical Genetics Craiova, County Emergency Hospital, Craiova, Romania
| | - Mihaela Popescu
- University of Medicine and Pharmacy of Craiova, Romania
- Filantropia Hospital, Craiova, Romania
| | - Mihaela-Eugenia Dinca
- University of Medicine and Pharmacy of Craiova, Romania
- Filantropia Hospital, Craiova, Romania
| | - Daniela-Gabriela Glavan
- University of Medicine and Pharmacy of Craiova, Romania
- Clinical Hospital of Neuropsychiatry, Craiova, Romania
| | - Ionela-Mihaela Vladu
- University of Medicine and Pharmacy of Craiova, Romania
- Filantropia Hospital, Craiova, Romania
| | - Mihai Ioana
- University of Medicine and Pharmacy of Craiova, Romania
- Regional Center of Medical Genetics Craiova, County Emergency Hospital, Craiova, Romania
| | - Ion Udristoiu
- University of Medicine and Pharmacy of Craiova, Romania
- Clinical Hospital of Neuropsychiatry, Craiova, Romania
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26
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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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27
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Mateo RCI, Hennessey JV. Thyroxine and treatment of hypothyroidism: seven decades of experience. Endocrine 2019; 66:10-17. [PMID: 31321670 PMCID: PMC6794242 DOI: 10.1007/s12020-019-02006-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/04/2019] [Indexed: 02/07/2023]
Abstract
Hypothyroidism is one of the most common endocrine disorders, affecting as much as 10% of the global population. There is a rich cultural milieu of treatment history and interventions dating as far back as 2 millennia. Chinese cretins were treated with sheep thyroid in the 6th century. In 1890, transplanted animal thyroid tissue resulted in a prompt clinical response in a myxedematous patient, and in 1891 injections of sheep thyroid were reported. One year later, the oral administration of fresh sheep thyroid glands was noted to be effective. Within a few years, the danger of over-dosage with extracts was recognized and dosing guidance indicated a low dose start and gradual increase as required based on symptoms. Orally ingested extracts became widespread and by 1914 thyroxine had been crystallized. In 1927, thyroxine, was synthesized as an acid, limiting oral absorption. Finally a sodium salt of thyroxine was introduced in 1949. These synthetic preparations were then made available for clinical use. Prior to 1970, extracts and combination therapy with synthetic LT4 and LT3 were standard replacement until the peripheral deiodinase-mediated T4 to T3 conversion documented the endogenous generation of T3 from LT4 in athyreotic subjects. This resulted in advocacy for patients previously treated with combinations and desiccated thyroid be transitioned to L-thyroxine monotherapy. The determination of the optimal dose has evolved such that now a general recommendation for replacement dosage of LT4 is 1.6-1.7 mcg/kg/day. Thyroid hormone extracts were established prior to the FDA's establishment in 1906, and when the Food, Drug, and Cosmetic act of 1938 enhanced the FDA's regulatory authority. In 1997, FDA declared LT4 products to be new drugs subject to regulation and quickly a pharmacokinetic process to determine interchangeability among approved LT4 products ensued. Differences in bioavailability of 12.5% or more may be considered therapeutically equivalent and therefore such products interchangeable. To assure refill to refill consistency, all levothyroxine sodium products now meet a 95-105% potency specification throughout their labeled shelf-lives. Seventy years after Kendall's great achievement in isolating thyroxine, we have thyroxine products with precise amounts of synthetic hormone that meet demanding regulations to assure high product quality, predictable bioavailability given its narrow therapeutic range, and now are left with potential variance in the therapeutic efficacy among different preparations.
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Affiliation(s)
- Roselyn Cristelle I Mateo
- Division of Endocrinology, Department of Medicine, Rush Medical College, Rush University Medical Center, Jelke Building 6th Floor, 1750 Harrison Street, Chicago, IL, 60612, USA.
| | - James V Hennessey
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Gryzmish 6, Boston, MA, 02215, USA
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28
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Erensoy H. The association between anxiety and depression with 25(OH)D and thyroid stimulating hormone levels. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2019; 24:290-295. [PMID: 31872808 PMCID: PMC8015556 DOI: 0.17712/nsj.2019.4.20190028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/04/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the relationships between the serum levels of these parameters and mood disorders, including depression and anxiety. METHODS One hundred and fifty patients (77 with anxiety and 73 with depression), aged 18 to 79 years old, who were referred to the Neuro Psychiatry Clinic of Uskudar University in Istanbul, Turkey were included in this study from June 2018 to December 2018. According to the Beck Anxiety Inventory and Beck Depression Inventory II results, the anxiety patients met the mild and moderate anxiety criteria and the depression patients met the moderate and severe depression criteria, respectively. Venous blood samples were collected after overnight fasting, and the 25(OH)D and thyroid stimulating hormone (TSH) levels were measured. RESULTS The data showed a significantly higher TSH level in the females when compared to their male counterparts in the severe depression subgroup (p=0.011). CONCLUSION A serum TSH evaluation may be considered as a useful biochemical marker for more efficient depression management.
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Affiliation(s)
- Habib Erensoy
- Department of Psychiatry, Faculty of Human and Social Sciences, Uskudar University, Istanbul, Turkey. E-mail:
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29
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Mohammad MYH, Bushulaybi NA, AlHumam AS, AlGhamdi AY, Aldakhil HA, Alumair NA, Shafey MM. Prevalence of depression among hypothyroid patients attending the primary healthcare and endocrine clinics of King Fahad Hospital of the University (KFHU). J Family Med Prim Care 2019; 8:2708-2713. [PMID: 31548961 PMCID: PMC6753820 DOI: 10.4103/jfmpc.jfmpc_456_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 06/24/2019] [Accepted: 07/12/2019] [Indexed: 02/07/2023] Open
Abstract
Context: Hypothyroidism is the most prevalent endocrine disorder worldwide, with a prevalence of 4%–5%. Thyroid hormone has a role in neurological development, and hormone deficiency can be manifested by many neurological signs and symptoms such as behavioral disturbances, anxiety, and depressive symptoms. Aims: To estimate the prevalence of depression among hypothyroid patients attending primary healthcare and endocrine clinic of King Fahad Hospital of the University (KFHU) and to assess the relationship between depression and different factors. Settings and Design: A cross-sectional study was conducted to estimate the prevalence of depression among hypothyroid patients attending the primary healthcare and endocrine clinics of KFHU in Al Khobar. Materials and Methods: Patients were screened for depression using Patient Health Questionnaire-9 screening tool, in addition to obtaining their sociodemographic data, details of their thyroid function status, and other risk factors for depression. Also, patient medical files were used to obtain the laboratory results. Statistical Analysis Used: Data were analyzed using the Statistical Package for the Social Science (SPSS) version 23. Continuous data were displayed using mean and standard deviation; categorical data were displayed in numbers and percentage. Chi-square test was used to assess the relationship between the variables. A P value of less than 0.05 was considered as statistically significant. Results: It was found that 33.9% of patients were depressed with varying degree of depression. Certain symptoms were found to be associated with higher risk of depression such as fatigue, memory problems, hair loss, and gland enlargement. Conclusion: Depression was concluded to be prevalent among hypothyroid patients. And screening for depression among hypothyroid patients is recommended.
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Affiliation(s)
- Maryam Y H Mohammad
- Medical Intern, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Naimah A Bushulaybi
- Medical Intern, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Aishah S AlHumam
- Medical Intern, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arwa Y AlGhamdi
- Medical Intern, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hala A Aldakhil
- Medical Intern, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nesreen A Alumair
- Medical Intern, Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Marwa M Shafey
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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30
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da Silva BS, Pietrobon CB, Bertasso IM, Lopes BP, Carvalho JC, Peixoto-Silva N, Santos TR, Claudio-Neto S, Manhães AC, Oliveira E, de Moura EG, Lisboa PC. Short and long-term effects of bisphenol S (BPS) exposure during pregnancy and lactation on plasma lipids, hormones, and behavior in rats. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 250:312-322. [PMID: 31003143 DOI: 10.1016/j.envpol.2019.03.100] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
Bisphenol S (BPS) has replaced bisphenol A (BPA), a known non-persistent endocrine disrupting chemical, in several products. Considering that little is known regarding BPS effects, especially during critical windows of ontogenetic development, and that BPA, which is quite similar to BPS, is know to be transferred to the offspring via the placenta and milk, in the present study we investigated the behavioral, biochemical and endocrine profiles of Wistar rats born from dams that were BPS-exposed [groups: BPS10 (10 μg/kg/day), BPS50 (50 μg/kg/day)] during pregnancy and lactation. Due to the non-monotonic dose-response effect of bisphenol, the data of both BPS groups were directly compared with those of the controls, not to each other. Males and females were analyzed separately. At weaning, male BPS50 offspring had hypotriglyceridemia and hyperthyroxinemia, whereas BPS50 females showed higher 25(OH)D levels. At adulthood, BPS offspring of both sexes had lower food intake. BPS males showed lower visceral adiposity. BPS50 females had smaller fat droplets in brown adipocytes. BPS males showed higher anxiety and higher locomotor activity, while BPS10 females showed lower exploration. During a food challenge test at adulthood, BPS males consumed more high-fat diet at 30 min. BPS10 females initially (at 30 min) consumed more high-fat diet but, after 12 h, less of this diet was consumed. BPS50 males had hypertriglyceridemia and lower plasma T3, while BPS females showed lower plasma T4. BPS10 females had lower progesterone, whereas BPS50 females had higher plasma 25(OH)D. Maternal BPS exposure has adverse effects on the triacylglycerol, hormones levels and behavior of the progeny. Furthermore, the increased preference for the fat-enriched diet suggests an increased risk for obesity and its health consequences in the long term.
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Affiliation(s)
- Beatriz Souza da Silva
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Carla Bruna Pietrobon
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Iala Milene Bertasso
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Bruna Pereira Lopes
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Janaine Cavalcanti Carvalho
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Nayara Peixoto-Silva
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Tatianne Rosa Santos
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Sylvio Claudio-Neto
- Laboratory of Neurophysiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Alex Christian Manhães
- Laboratory of Neurophysiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Elaine Oliveira
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Egberto Gaspar de Moura
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - Patrícia Cristina Lisboa
- Laboratory of Endocrine Physiology, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, RJ, Brazil.
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31
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Hepp Z, Lage MJ, Espaillat R, Gossain VV. The association between adherence to levothyroxine and economic and clinical outcomes in patients with hypothyroidism in the US. J Med Econ 2018; 21:912-919. [PMID: 29865926 DOI: 10.1080/13696998.2018.1484749] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate outcomes associated with adherence to levothyroxine (LT4) in the US adult hypothyroidism population. METHODS We used data from Truven's MarketScan databases from 1 July 2011 through 31 December 2015. Patients aged 18 or older were diagnosed with hypothyroidism (confirmed at least twice) and prescribed LT4. Patients were excluded if they did not have continuous insurance coverage or if they received a diagnosis of thyroid cancer or pregnancy during the study period. Multivariable analyses on a matched cohort of adherent and nonadherent patients examined the relationships among patient outcomes and adherence, defined as the proportion of days covered ≥80%. Outcomes included all-cause and hypothyroidism-related medical costs and resource utilization and comorbid diagnoses measured over the 1 year post-period following the first prescription for LT4. The analyses controlled for patient age, sex, region of residence, type of insurance coverage, diagnosing physician and pre-period general health status as proxied by the Charlson Comorbidity Index. RESULTS Prior to matching, there were 168,457 patients identified as adherent and 198,443 patients identified as nonadherent. The matched cohort consisted of 318,628 individuals, with equal numbers of adherent and nonadherent patients (n = 159,314). Patients who were adherent used significantly fewer resources and had significantly lower all-cause ($14,136 vs. $14,926; p < .0001) and hypothyroidism-related ($1672 vs. $1709; p < .0001) total costs, although the costs of drugs were higher in the adherent group. Furthermore, adherent patients, compared to nonadherent patients, were significantly less likely to be diagnosed with comorbid Addison's disease, bipolar disorder, chronic kidney disease, depression, migraine, obesity, type 1 diabetes or type 2 diabetes during the follow-up period. CONCLUSIONS Compared to nonadherence, adherence to LT4 among patients with hypothyroidism was associated with a significant reduction in all-cause and hypothyroidism-related costs and resource utilization as well as significantly lower rates of many comorbid diagnoses.
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Affiliation(s)
- Zsolt Hepp
- a Formerly Global Health Economics and Outcomes Research Analytics, AbbVie Inc. , North Chicago , IL , USA
| | - Maureen J Lage
- b HealthMetrics Outcomes Research , Bonita Springs , FL , USA
| | - Ramon Espaillat
- c US Medical Affairs , Endocrinology and Metabolics, AbbVie Inc. , North Chicago , IL , USA
| | - Ved V Gossain
- d Division of Endocrinology , Michigan State University , East Lansing , MI , USA
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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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Qu P, Yu JX, Xia L, Chen GH. Cognitive Performance and the Alteration of Neuroendocrine Hormones in Chronic Tension-Type Headache. Pain Pract 2017; 18:8-17. [PMID: 28339138 DOI: 10.1111/papr.12574] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/19/2017] [Accepted: 01/28/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Ping Qu
- Department of Neurology; The First Affiliated Hospital of Anhui Medical University; Hefei China
- Department of Neurology; The Second Affiliated Hospital of Anhui Medical University; Hefei China
| | - Jin-Xia Yu
- Official Hospital of the People's Government; Hefei Anhui Province China
| | - Lan Xia
- Department of Neurology; The Second Affiliated Hospital of Anhui Medical University; Hefei China
| | - Gui-Hai Chen
- Department of Neurology; The First Affiliated Hospital of Anhui Medical University; Hefei China
- Departments of Neurology and General Practice; The Affiliated Chaohu Hospital of Anhui Medical University; Hefei China
- Psychologic Medical Center of Anhui Medical University; Hefei China
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Gałecka E, Kumor-Kisielewska A, Orzechowska A, Maes M, Górski P, Szemraj J. Assessment of type 1 and type 3 deiodinase expression levels in depressive disorders. Acta Neurobiol Exp (Wars) 2017. [DOI: 10.21307/ane-2017-056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bathla M, Singh M. Reply to "How prevalent are depression and anxiety symptoms in hypothyroidism?". Indian J Endocrinol Metab 2016; 20:883-884. [PMID: 27867900 PMCID: PMC5105581 DOI: 10.4103/2230-8210.192913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Manish Bathla
- Department of Psychiatry, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Manpreet Singh
- Department of Psychiatry, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
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Praharaj SK. How prevalent are depression and anxiety symptoms in hypothyroidism? Indian J Endocrinol Metab 2016; 20:882-883. [PMID: 27867899 PMCID: PMC5105580 DOI: 10.4103/2230-8210.192906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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