title: A paradoxical difference in relationship between anxiety, depression and thyroid function in subjects on and not on T4: findings from the HUNT study.
abstract: OBJECTIVE
  There have been conflicting reports on the relationship between thyroid function and mood between studies in subjects on T4 and the general population not on T4. We investigated this relationship in a large catchment area-based study.
  
  
  METHODS
  We analysed data on serum TSH levels and Hospital Anxiety and Depression Scale (HADS) scores from the HUNT 2 study (age > or = 40 years). Following a test for interaction, analyses were performed separately in females on T4 (n = 1265) and in people not on T4 (males n = 9319 and females n = 17 694).
  
  
  RESULTS
  More females on T4 had high depression and anxiety scores than females not on T4 (depression 18.4%vs. 13.0%, P < 0.001, anxiety 23.4%vs. 18.7%, P < 0.001). In those not on T4, there was an inverse association between serum TSH and depression score in males (B coefficient = -0.61, 95% CI -0.91 to -0.24, P = 0.001) though not in females (B coefficient = -0.07, -0.33 to 0.19), and an inverse association between TSH and anxiety score in both genders (B coefficient for males = 0.68, 95% CI -1.04 to -0.32, P < 0.001; females -0.37, 95% CI -0.67 to -0.08, P = 0.01). In contrast, in females on T4, TSH was positively associated with both depression (B coefficient = +0.27, 95% CI 0.02 to 0.51, P < 0.05) and anxiety (B coefficient = +0.29, 95% CI 0.01 to 0.56, P < 0.05).
  
  
  CONCLUSIONS
  There is a different relationship between thyroid function and depression and anxiety in females on T4 compared with individuals with no thyroid disease. This group also has a higher prevalence of depression and anxiety.
authors.affiliation: Henry Wellcome Laboratories for Integrative Neurosciences and Endocrinology, University of Bristol, Whitson Street, Bristol, United Kingdom.
authors.forename: Vijay
authors.initials: V
authors.lastname: Panicker
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.forename: Trine
authors.initials: T
authors.lastname: Bjøro
authors.forename: Bjorn O
authors.initials: BO
authors.lastname: Asvold
authors.forename: Colin M
authors.initials: CM
authors.lastname: Dayan
authors.forename: Ottar
authors.initials: O
authors.lastname: Bjerkeset
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects*; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013959:Thyroid Diseases / Q000188:drug therapy / Q000453:epidemiology; D013961:Thyroid Gland / Q000502:physiology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*
chemical_list: D013972:Thyrotropin; D013974:Thyroxine