title: Association between autoimmune thyroiditis and depressive disorder in psychiatric outpatients.
abstract: Thyroid diseases are often associated with psychiatric disorders. The prevalence of autoimmune thyroiditis in the general population is estimated to be at about 5-14 %. A clinical study was conducted to evaluate the association between autoimmune thyroiditis and depression in psychiatric outpatients. Fifty-two patients with depression and nineteen patients with schizophrenia (serving as control group), attending a psychiatric outpatient unit, were included. In addition to the measurement of thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase (anti-TPO) antibodies, and anti-thyroglobulin antibodies, ultrasound examination of the thyroid gland was performed. The proportion of pathologically increased anti-TPO levels in patients with depression was high. Furthermore, the distribution of pathologically increased anti-TPO levels was significantly (χ (2) = 5.5; p = 0.019) different between patients with depression (32.7 %) and patients with schizophrenia (5.3 %). In a gender- and age-adjusted logistic regression, the odds ratio of uni- or bipolar patients with depression for an autoimmune thyroiditis was ten times higher (95 % CI = 1.2-85.3) when compared with schizophrenia patients. TSH basal level did not differ between patients with depression and patients with schizophrenia. Our study demonstrates a strong association between anti-TPO levels, which are considered to be of diagnostic value for autoimmune thyroiditis (in combination with a hypoechoic thyroid in ultrasonography) with uni- or bipolar depression. It should be noted that the routinely measured TSH level is not sufficient in itself to diagnose this relevant autoimmune comorbidity.
authors.affiliation: Department of Psychiatry and Psychotherapy, Georg-August University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany, ddegner@gwdg.de.
authors.forename: Detlef
authors.initials: D
authors.lastname: Degner
authors.forename: Merle
authors.initials: M
authors.lastname: Haust
authors.forename: Johannes
authors.initials: J
authors.lastname: Meller
authors.forename: Eckart
authors.initials: E
authors.lastname: Rüther
authors.forename: Udo
authors.initials: U
authors.lastname: Reulbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood / Q000150:complications*; D003866:Depressive Disorder / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000097:blood / Q000150:complications*; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000150:complications*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D055815:Young Adult
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine