Affective disorders associated with autoimmune thyroiditis.

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Back to table of contents Previous article Next article LetterFull AccessAffective Disorders Associated With Autoimmune ThyroiditisDetlef Degner, M.D., Johannes Meller, M.D., Stefan Bleich, M.D., Volker Schlautmann, and Eckart RÜther, M.D., Detlef DegnerSearch for more papers by this author, M.D., Johannes MellerSearch for more papers by this author, M.D., Stefan BleichSearch for more papers by this author, M.D., Volker SchlautmannSearch for more papers by this author, and Eckart RÜtherSearch for more papers by this author, M.D., Departments of Psychiatry/Psychology and Nuclear Medicine, University of Göttingen, GermanyPublished Online:1 Nov 2001AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail SIR: Mood disorders often are associated with thyroid dysregulations, particularly depressions with autoimmune thyroiditis.1,2 In the general population, the prevalence rate of autoimmune thyroiditis (Hashimoto's disease) is about 5% to 12%1,2 (depending on the criteria used for definition), and it manifests with characteristic, though unspecific, high titers of autoantibodies, but not always with clinical symptoms.2,3 The goal of this study was to investigate thyroid diseases in psychotic patients in view of the prevalence of autoimmune thyroiditis in clinical practice.In a retrospective study design, all files of inpatients with affective or schizoaffective disorders or schizophrenia (DSM-IV criteria) from the Department of Psychiatry and Psychology, University of Göttingen, Germany, were evaluated between January 1994 and May 2000. Blood thyroid hormones in vitro (T3, T4, TSH) were examined, autoantibodies to thyroid peroxidase (anti-TPO) were analyzed by a DYNO anti-TPO assay (BRAHMS Diagnostica, Berlin, Germany; cutoff for positivity >60 U/ml). In all, out of 1,782 inpatients with acute psychosis, 109 patients (6.1%; 64 females, 45 males; mean age 48.4 years) had pathological thyroid findings. We found 20 patients (15 females, 5 males; mean age 61.9 years) with an autoimmune thyroiditis. Of these, 6 patients suffered from hypothyroidism, 2 patients from hyperthyroidism, and the other 12 had an euthyroid status. One patient met the criteria for a Hashimoto encephalopathy.4 Relevant factors for an autoimmune thyroiditis were gender and age of patients and type of psychiatric diagnosis (depressive disorder, n=11; bipolar disorder, n=5; schizoaffective disorder, n=3; schizophrenia, n=1).We observed strong differences between different subtypes of depressive disorders in their association with autoimmune thyroiditis. Most patients with autoimmune thyroiditis were suffering from a unipolar recurrent major depression. There was no trend to a higher prevalence of autoimmune thyroiditis in affective disorders in comparison to the general population. The higher prevalence rates of Hashimoto's disease in women and in older patients were expected from the literature.5Autoimmune thyroid dysfunctions warrant further testing in patients with acute mood disorders (e.g., additional sonography, needle biopsy) and probably offer new immunological considerations for psychopathology, etiology, and nosology of affective disorders and for treatment of risk groups (elderly women and nonresponders). Psychotic diseases and associated dysfunctions of the hypothalamus-pituitary-thyroid axis possibly are a complex interdependent system, and the coexistence of Hashimoto's thyroiditis and affective disorders may be an effect of common biological pathways.References1 Placidi GP, Boldrini M, Patronelli A, et al: Prevalence of psychiatric disorders in thyroid-diseased patients. Neuropsychobiology 1998; 38:222-225Crossref, Medline, Google Scholar2 Flynn SD, Nishiyama RH, Bogos ST: Autoimmune thyroid disease: immunological, pathological, and clinical aspects. Crit Rev Clin Lab Sci 1988; 26:43-93Crossref, Medline, Google Scholar3 König F, v Hippel C, Petersdorff T, et al: Thyroid autoantibodies in depressive disorders. Acta Med Austriaca 1999; 26:126-128Medline, Google Scholar4 Korthbauer-Margreiter I, Sturzenegger M, Komor J, et al: Encephalopathy associated with Hashimoto thyroiditis: diagnosis and treatment. J Neurol 1996; 243:585-593Crossref, Medline, Google Scholar5 Hall RCW, Popkin MK, Vaul RD, et al: Psychiatric manifestations of Hashimoto's thyroiditis. Psychosomatics 1982; 23:337-342Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByThe Impact of the COVID-19 Pandemic on Psychological Health and Insomnia among People with Chronic Diseases14 March 2021 | Journal of Clinical Medicine, Vol. 10, No. 6No Effect of Thyroid Dysfunction and Autoimmunity on Health-Related Quality of Life and Mental Health in Children and Adolescents: Results From a Nationwide Cross-Sectional Study2 September 2020 | Frontiers in Endocrinology, Vol. 11European Archives of Psychiatry and Clinical Neuroscience, Vol. 265, No. 1Psychological Medicine, Vol. 45, No. 16 Volume 13Issue 4 November 2001Pages 532-533 Metrics History Published online 1 November 2001 Published in print 1 November 2001