Thyroid Dysfunction Associated with Depressive Disorder: A Descriptive Cross-Sectional Study Done in a Tertiary Care Center of Eastern Nepal

S. Rizal, M. Acharya, S. Regmi, B. Joshi, S. Jha, Dikshya Rana
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Abstract

Background: Depression is one of the most common psychiatric disorders with substantial morbidity and mortality. It is known to be associated with changes in the hypothalamic-pituitary-thyroid axis, thus may be accompanied by subtle thyroid dysfunction. Thus, our study aims to determine the prevalence and characteristics of thyroid dysfunction in newly diagnosed depressive patients. Materials and Methods: A prospective descriptive cross sectional study was conducted among 130 patient diagnosed as depression from December 2020 to June 2022 after taking the ethical approval. The patients in the symptomatic phase and above 18 years was recruited in our study. Thyroid profile consisting of free tri-iodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) was estimated by chemiluminescence immunoassay in the central laboratory of Nobel Medical College Teaching Hospital. Results: Out of 130 depressive patients recruited in our study, 44 patients had abnormal thyroid function test showing a prevalence of 33.84%. The most common form was moderate depression which was 39.99% of our study population. The commonest thyroid abnormality was subclinical hypothyroidism (15.38%) followed by overt hypothyroidism (14.61%). Thyroid abnormality was more common among the severe form of depression (46.66%). The comparison of means of fT3, fT4 and TSH between different grades of depression was statistically significant for fT3 (p=0.048) and TSH (p=0.001). Conclusion: Thus, the most common thyroid function abnormalities in our study include subclinical and overt hypothyroidism, with associated lower level of fT4 and higher level of TSH.
与抑郁症相关的甲状腺功能障碍:尼泊尔东部一家三级护理中心的描述性横断面研究
背景:抑郁症是最常见的精神疾病之一,发病率和死亡率都很高。众所周知,它与下丘脑-垂体-甲状腺轴的变化有关,因此可能伴有轻微的甲状腺功能障碍。因此,我们的研究旨在确定新诊断的抑郁症患者甲状腺功能障碍的患病率和特征。材料和方法:在获得伦理批准后,于2020年12月至2022年6月对130名被诊断为抑郁症的患者进行了前瞻性描述性横断面研究。我们的研究招募了症状期和18岁以上的患者。在诺贝尔医学院教学医院中心实验室,用化学发光免疫分析法测定了由游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)组成的甲状腺谱,44例患者甲状腺功能异常,患病率为33.84%。最常见的形式是中度抑郁症,占我们研究人群的39.99%。最常见的甲状腺异常是亚临床甲状腺功能减退症(15.38%),其次是显性甲状腺功能低下症(14.61%)。甲状腺异常在严重的抑郁症中更常见(46.66%)。不同级别抑郁症的fT3、fT4和TSH平均值比较,fT3(p=0.048)和TSH(p=0.001)具有统计学意义。结论:因此,在我们的研究中,最常见的甲状腺功能异常包括亚临床和显性甲状腺功能减退,并伴有较低水平的fT4和较高水平的TSH。
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