[Evaluation of clinical and psychiatric symptoms in sub clinical hypothyroidism].
BACKGROUND
This investigation evaluated and correlated clinical, laboratorial aspects and psychiatric symptoms in sub clinical hypothyroidism (SH).


METHODS
Cross sectional study involving 103 patients with SH and 60 subjects without thyroid disease. Clinical and psychiatric evaluation was respectively based on the Zulewski score and Hamilton A, Hamilton D and Beck questionnaires. Serum thyreotropin (TSH), (thyroxine) FT4 and (antithyroperoxidase) ATPO were measured in all participants. Analysis of continuums data was assessed by the Student t- test, for normally distributed data, and by the Mann- Whitney and Kruskal Wallis tests for non-parametric data. The chi2, Fisher's and Kruskal Wallis tests were used to study qualitative variables. Multivariate analyses were used to study confounding variables.


RESULTS
Mean serum TSH level was 7.76 +/- 2.9 micro UI/mL in SH and 1.66 +/- 0.6 micro UI/mL in the group without thyroid disease (p=0.001). Mean serum T4L was slightly lower among patients with HS, and showed a negative linear correlation with TSH. Higher frequencies of abnormal clinical score (48.3 vs. 67.0%; p=0.02), depression self reported symptoms (20.5 vs. 44.2%; p=0.011) and anxiety symptoms (86.0 vs. 63.4%; p=0.004) occurred more frequently in SH. Frequency of psychiatric symptoms had a positive correlation with the clinical score and serum TSH. There was no association between the clinical and psychiatric findings and the etiology of SH, presence of ATPO, age or menopause.


CONCLUSIONS
The study showed that SH was associated with clinical findings and with psychiatric symptoms. Clinical trials are required to evaluate possible improvement with levotiroxine.
Teixeira
Patrícia de Fátima Dos Santos
Pde F
Serviços de Endocrinologia e de Psicologia Médica do Hospital Universitário Clementino Fraga Filho. patricia.hu@terra.com.br
Reuters
Vaneska Spinelli
VS
Almeida
Cloyra Paiva
CP
Ferreira
Márcia Martins
MM
Wagman
Márcia Branco
MB
Reis
Fabíola Alves Aarão
FA
Costa
Antonio José Leal
AJ
Vaisman
Mário
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000906:Antibodies / Q000097:blood*; D001008:Anxiety Disorders / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy / Q000276:immunology / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010544:Peroxidases / Q000097:blood*; D018709:Statistics, Nonparametric; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood
D000906:Antibodies; D015415:Biomarkers; D013972:Thyrotropin; D010544:Peroxidases; D013974:Thyroxine