title: Mood and thyroid immunity assessed by ultrasonographic imaging in a primary health care.
abstract: BACKGROUND
  Psychiatric morbidity is highly prevalent in the primary health care settings and it may be related to autoimmune thyroid disease (AITD). The aim of this study was to evaluate the impact of thyroid immunity, evident by hypo-echoic thyroid ultrasound pattern, on prevalence of depression and anxiety in a primary care setting.
  
  
  METHODS
  In a cross-sectional design, 504 consecutive primary care patients were invited to the study and 474 patients completed the study. They were screened for depression and anxiety using the Hospital Anxiety and Depression Scale (HADS), were interviewed for affective disorders using the Mini International Neuropsychiatric Interview, and were evaluated by ultrasonographic imagining of the thyroid gland.
  
  
  RESULTS
  Among patients with hypo-echoic thyroid (n=122) prevailed women and those patients were older than patients with normo-echoic thyroid (n=352). Women, but not men, with hypo-echoic thyroid compared to those with normo-echoic thyroid had higher scores on the anxiety subscale of the HADS (p=0.03). Among women with hypo-echoic thyroid, only those pre-menopause, but not those post-menopause, had greater prevalence of high scores on the depression subscale of the HADS (p=0.02) and a greater likelihood of using psychiatric medications (p=0.001).
  
  
  CONCLUSIONS
  Lack of cytological evaluation of the thyroid gland; lack of serum thyroid antibodies concentrations; and lack of thyroid hormone concentrations.
  
  
  CONCLUSIONS
  Thyroid immunity is related to mood symptoms in primary care patients. These effects are gender specific and in women, they are most evident before menopause.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA. robertas_bunevicius@med.unc.edu
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
authors.forename: Jurate
authors.initials: J
authors.lastname: Peceliuniene
authors.forename: Narseta
authors.initials: N
authors.lastname: Mickuviene
authors.forename: Adomas
authors.initials: A
authors.lastname: Bunevicius
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Pop
authors.forename: Susan S
authors.initials: SS
authors.lastname: Girdler
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015984:Causality; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006111:Graves Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012737:Sex Factors; D013223:Statistics as Topic; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013967:Thyroiditis, Autoimmune / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014463:Ultrasonography