title: Bipolar disorder and antithyroid antibodies: review and case series.
abstract: Mood disorders and circulating thyroid antibodies are very prevalent in the population and their concomitant occurrence may be due to chance. However, thyroid antibodies have been repeatedly hypothesized to play a role in specific forms of mood disorders. Potentially related forms include treatment-refractory cases, severe or atypical depression, and depression at specific phases of a woman's life (early gestation, postpartum depression, perimenopausal). With regard to bipolar disorder, studies of specific subgroups (rapid cycling, mixed, or depressive bipolar) have reported associations with thyroid antibodies. Offspring of bipolar subjects were found more vulnerable to develop thyroid antibodies independently from the vulnerability to develop psychiatric disorders. A twin study suggested thyroid antibodies among possible endophenotypes for bipolar disorder. Severe encephalopathies have been reported in association with Hashimoto's thyroiditis. Cases with pure psychiatric presentation are being reported, the antithyroid antibodies being probably markers of some other autoimmune disorders affecting the brain. Vasculitis resulting in abnormalities in cortical perfusion is one of the possible mechanisms.
authors: Unit of Clinical Pharmacology, Section of Neurosciences, Department of Biomedical Sciences, "San Giovanni di Dio" Hospital, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. bocchett@unica.it.
authors: Alberto
authors: A
authors: Bocchetta
authors: Unit of Clinical Pharmacology, Section of Neurosciences, Department of Biomedical Sciences, "San Giovanni di Dio" Hospital, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. francesco.traccis@gmail.com.
authors: Francesco
authors: F
authors: Traccis
authors: Unit of Clinical Pharmacology, Section of Neurosciences, Department of Biomedical Sciences, "San Giovanni di Dio" Hospital, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. mosca@unica.it.
authors: Enrica
authors: E
authors: Mosca
authors: Department of Medical Sciences "Mario Aresu", University of Cagliari, Cagliari, Italy. aserra@medicina.unica.it.
authors: Alessandra
authors: A
authors: Serra
authors: Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. tamburin@unica.it.
authors: Giorgio
authors: G
authors: Tamburini
authors: Department of Medical Sciences "Mario Aresu", University of Cagliari, Cagliari, Italy. alovise@medicina.unica.it.
authors: Andrea
authors: A
authors: Loviselli
keywords: Bipolar disorders; Depression; Hashimoto’s encephalopathy; Hashimoto’s thyroiditis; Lithium; Mood disorders; Thyroglobulin antibodies; Thyroid microsomal antibodies; Thyroid peroxidase antibodies