Depression and hypothyroidism: A systematic review
DOI:
https://doi.org/10.31211/rpics.2023.9.2.314Keywords:
Depression, Hypothyroidism, Major Depressive Disorder, Neuroendocrine Disorders, Systematic ReviewAbstract
Background and Objective: Given the global prevalence of depressive disorders and their potential association with neuroendocrine conditions like hypothyroidism, this study aimed to explore the relationship between hypothyroidism and depression or depressive symptoms. Methods: Using databases such as PubMed, Embase, and CAPES, and following the PRISMA methodology, studies published between 2018 and 2022 were selected. The inclusion criteria encompassed articles in English, Spanish, or Portuguese, using various diagnostic methods, including laboratory tests and clinical interviews or psychological scales. Reviews, animal studies, and other types of non-primary publications were excluded. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Results:Among the 14 selected articles, a significant association between hypothyroidism and depression emerged, particularly in women, including those undergoing hormone replacement therapy. However, data on the relationship between subclinical hypothyroidism and depression were conflicting. Additionally, hypothyroidism as a comorbidity in major depressive disorder may contribute to severe clinical outcomes. Conclusions: These results suggest a possible association between hypothyroidism and depression. This finding underscores the importance of evaluating thyroid function in depressed patients, especially women, for effective diagnosis and treatment, aligned with evidence-based clinical practice.
Downloads
References
Airaksinen, J., Komulainen, K., García-Velázquez, R., Määttänen, I., Gluschkoff, K., Savelieva, K., & Jokela, M. (2021). Subclinical hypothyroidism and symptoms of depression: Evidence from the National Health and Nutrition Examination Surveys (NHANES). Comprehensive Psychiatry, 109, Artigo 152253. https://doi.org/gqp5kp
Almeida, M. M. R., Kuwae, A. S., Quirino, C. M. J., Gondim, L. V., & Silva, D. O. F. (2013). A depressão e sua relação com o hipotireoidismo. Revista de Medicina e Saúde de Brasília, 2(3), 164–169. https://bit.ly/3Rm2IRb
Altshuler, L. L., Bauer, M., Frye, M. A., Gitlin, M. J., Mintz, J., Szuba, M. P., Leight, K. L., & Whybrow, P. C. (2001). Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. The American Journal of Psychiatry, 158(10), 1617–1622. https://doi.org/dqf38j
American Psychiatry Association. (2014). Manual diagnóstico e estatístico de transtornos mentais (5.ª ed.). Artmed.
Bauer, M., Heinz, A., & Whybrow, P. C. (2002). Thyroid hormones, serotonin and mood: Of synergy and significance in the adult brain. Molecular Psychiatry, 7(2), 140–156. https://doi.org/b83vvz
Bauer, M., & Whybrow, P. C. (2021). Role of thyroid hormone therapy in depressive disorders. Journal of Endocrinological Investigation, 44(11), 2341–2347. https://doi.org/k56v
Beck, A., Crain, A. L., Solberg, L. I., Unützer, J., Glasgow, R. E., Maciosek, M. V., & Whitecird, R. (2011). Severity of depression and magnitude of productivity loss. The Annals of Family Medicine, 9(4) 305–311. https://doi.org/bkf3hg
Bitencourt, F. V., Oliveira, L. B., Massignan, C., Stefani, C. M., & Canto, G. D. L. (2021). Análise da qualidade metodológica de estudos observacionais (coorte e caso-controle) com a ferramenta Newcastle-Ottawa Scale (NOS). Em G. de Luca Canto, C. Miron Stefani, & C. Massignan (Eds.), Risco de viés em revisões sistemáticas: guia prático (Cap. 10). Centro Brasileiro de Pesquisas Baseadas em Evidências – COBE UFSC. https://bit.ly/3uxyhyy
Bode, H., Ivens, B., Bschor, T., Schwarzer, G., Henssler, J., & Baethge, C. (2021). Association of hypothyroidism and clinical depression: A systematic review and meta-analysis. JAMA Psychiatry, 78(12), 1375–1383. https://doi.org/gqqwg4
Chang, B. P., Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., & Nock, M. K. (2016). Biological risk factors for suicidal behaviors: A meta-analysis. Translational Psychiatry, 6(9), Artigo e887. https://doi.org/f9ccmq
Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: Where we’ve been and where we’re going. Advances in Therapy, 36, 47–58. https://doi.org/ghnggk
Choi, K. W., Kim, Y., Fava, M., Mischoulon, D., Na, E. J., Kim, S. W., Shin, M.-H., Chung, M. K., & Jeon, H. J. (2019). Increased morbidity of major depressive disorder after thyroidectomy: A nationwide population-based study in South Korea. Thyroid, 29(12), 1713–1722. https://doi.org/k56z
Fugger, G., Dold, M., Bartova, L., Kautzky, A., Souery, D., Mendlewicz, J., Serretti, A., Zohar, J., Montgomery, S., Frey, R., & Kasper, S. (2018). Comorbid thyroid disease in patients with major depressive disorder-results from the European Group for the Study of Resistant Depression (GSRD). European Neuropsychopharmacology, 28(6), 752–760. https://doi.org/gdt285
Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber, K. (2012). Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice, 18(6), 988–1028. https://doi.org/gbcfsn
Gorkhali, B., Sharma, S., Amatya, M., Acharya, D., & Sharma, M. (2020). Anxiety and depression among patients with thyroid function disorders. Journal of Nepal Health Research Council, 18(3), 373–378. https://doi.org/k562
Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H., Kessler, R. C. (2021). The economic burden of adults with major depressive disorder in the United States (2010 and 2018). PharmacoEconomic, 39, 653–665. https://doi.org/gnwsqc
Gunes, N. A. (2020). Evaluation of anxiety and depression in patients with thyroid function disorder. Revista da Associação Médica Brasileira, 66(7), 979–985. https://doi.org/k563
Hage, M. P., & Azar, S. T. (2012). The link between thyroid function and depression. Journal of Thyroid Research, 2012, Artigo 590648. https://doi.org/c6bzfn
Herzog, R., Álvarez-Pasquin, M., Díaz, C., Del Barrio, J. L., Estrada, J. M., & Gil, Á. (2013). Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health, 13(1), 1–17. https://doi.org/gbczmv
Hong, J. W., Noh, J. H., & Kim, D. J. (2018). Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey. PLoS One, 13(8), Artigo e0202258. https://doi.org/k564
Kafle, B., Khadka, B., & Tiwari, M. L. (2020). Prevalence of thyroid dysfunction among depression patients in a tertiary care centre. Journal of the Nepal Medical Association, 58(229), Artigo 654. https://doi.org/k565
Kamyshna, I., Pavlovych, L., & Kamyshnyi, A. M. (2022). Prediction of the development of depression in patients with autoimmune thyroiditis and hypothyroidism. Open Access Macedonian Journal of Medical Sciences, 10(B), 137–145. https://doi.org/k566
Kim, J. S., Zhang, Y., Chang, Y., Ryu, S., Guallar, E., Shin, Y. C., Shin, H., Lim, S.-W., & Cho, J. (2018). Subclinical hypothyroidism and incident depression in young and middle-age adults. The Journal of Clinical Endocrinology & Metabolism, 103(5), 1827–1833. https://doi.org/k567
Kim, M. D., Yang, H. J., Kang, N. R., Park, J. H., & Jung, Y. E. (2020). Association between subclinical hypothyroidism and metabolic syndrome among individuals with depression. Journal of Affective Disorders, 264, 494–497. https://doi.org/grzrvb
Kim, W. B., Woo, G., Kim, H., Cho, Y., Kim, T. Y., Kim, S. W., Shin, M.-H., Park, J. W., Park, H.-L., Oh, K., & Chung, J. H. (2017). Thyroid stimulating hormone reference range and prevalence of thyroid dysfunction in the Korean population: Korea National Health and Nutrition Examination Survey 2013 to 2015. Endocrinolology and Metabolism, 32(1), 106–114. https://doi.org/k568
Kuehner, C. (2017). Why is depression more common among women than among men? The Lancet. Psychiatry, 4(2), 146–158. https://doi.org/f9r4q7
Lang, X., Hou, X., Shangguan, F., & Zhang, X. Y. (2020). Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese. Journal of Affective Disorders, 263, 507–515. https://doi.org/gqtxv7
Loh, H. H., Lim, L. L., Yee, A., & Loh, H. S. (2019). Association between subclinical hypothyroidism and depression: An updated systematic review and meta-analysis. BMC Psychiatry, 19(1), Artigo 12. https://doi.org/ggxc3g
Selçuk, A. A. (2019). A guide for systematic reviews: PRISMA. Turkish Archives of Otorhinolaryngology, 57(1), 57–58. https://doi.org/k569
Shen, Y., Wu, F., Zhou, Y., Ma, Y., Huang, X., Ning, Y., Lang, X., Luo, X., & Zhang, X. (2019). Association of thyroid dysfunction with suicide attempts in first-episode and drug naïve patients with major depressive disorder. Journal of Affective Disorders, 259, 180–185. https://doi.org/gjg782
Taylor, P. N., Albrecht, D., Scholz, A., Gutierrez-Buey, G., Lazarus, J. H., Dayan, C. M., & Okosieme, O. E. (2018). Global epidemiology of hyperthyroidism and hypothyroidism. Nature Reviews Endocrinology, 14(5), 301–316. https://doi.org/gc724p
Toloza, F. J. K., Mao, Y., Menon, L., George, G., Borikar, M., Thumma, S., Motahari, H., Erwin, P., Owen, R., & Maraka, S. (2021). Association of thyroid function with suicidal behavior: A systematic review and meta-analysis. Medicina, 57(7), Artigo 714. https://doi.org/k56w
Wells, G. A., Shea, B., O'Connell, D., Peterson, J., Welch, V., Losos, M., & Tugwell, P. (2014). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. The Ottawa Hospital Research Institute. https://bit.ly/47B5vM7
Wildisen, L., Giovane, C. D., Moutzouri, E., Beglinger, S., Syrogiannouli, L., Collet, T. H., Cappola, A. R., Åsvold, B. O., Bakker, S. J. L., Yeap, B. B., Almeida, O. P., Ceresini, G., Dullaart, R. P. F., Ferrucci, L., Grabe, H., Jukema, J. W., Nauck, M., Trompet, S., Völzke, H., ... Rodondi, N. (2020). An individual participant data analysis of prospective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms. Scientific Reports, 10(1), 1–12. https://doi.org/gjw3vw
World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. https://bit.ly/3sYK6h2
Yuan, L., Luan, D., Xu, X., Yang, Q., Huang, X., Zhao, S., Zhang, Y., & Zhou, Z. (2020). Altered attention networks in patients with thyroid dysfunction: A neuropsychological study. Hormones and Behavior, 121, Artigo 104714. https://doi.org/k56x
Zhao, S., Chen, Z., Wang, X., Yao, Z., & Lu, Q. (2021). Increased prevalence of subclinical hypothyroidism in female hospitalized patients with depression. Endocrine, 72(2), 479–485. https://doi.org/gmq72t
Zhou, Y., Ma, Y., Wu, Q., Wang, Q., Yang, W. F. Z., Wang, Y., Yang, D., Luo, Y., Tang, K., Liu, T., & Wang, D. (2021). Comparison of thyroid hormone levels between patients with major depressive disorder and healthy individuals in China. Frontiers in Psychiatry, 12, Artigo 750749. https://doi.org/k57b
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Eduarda Silva Souza, Rosangela Soares Chriguer, Maria Cristina Mazzaia
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The authors retain the copyright and grant the journal right of first publication with the work simultaneously licensed under the Creative Commons Attribution-NonCommercial 4.0 International License that allows the sharing of work and recognition of authorship and initial publication in this journal.