CENTER ON BEHAVIORAL MEDICINE

BODY-MIND CONNECTION

DISEASE

Disease:  Research Article

Disease Menu

Subclinical Hypothyroidism: A Modifiable Risk Factor for Depression?

CITATION:  Haggerty, J.J., Stern, R.A., et al. (1993).  Subclinical Hypothyroidism: A Modifiable Risk Factor for Depression? Am J Psychiatry 150:508-510.

ABSTRACT:   Subclinical hypothyroidism is a common endocrinopathy that is defined by laboratory findings of an elevated basal thyroid-stimulating hormone (TSH) concentration or an exaggerated TSH response to thyrotropin-releasing hormone (TRH) stimulation in the presence of normal thyroid hormone concentrations (1). Although the typical somatic manifestations of thyroid hormone deficiency are usually absent in subclinical hypothyroidism, it has been proposed that subclinical hypothyroidism may share with overt hypothyroidism the capacity to cause depression (2, 3). Support for this hypothesis comes mainly from studies that have evaluated thyroid function in selected psychiatric populations (2, 4). To date, however, no study has directly examined the psychiatric effects of subclinical hypothyroidism in individuals who are not seeking psychiatric treatment. We therefore report the results of a controlled evaluation of the lifetime occurrence of depression in relatively healthy outpatients with untreated subclinical hypothyroidism.

References

1. Evered DC, Ormston BJ, Smith PA, Hall R, Bird T: Grades of hypothyroidism. Br Med j 1973; 1:657-662

2. Gold MS, Pottash ALC, Extein I: Hypothyroidism and depression: evidence from complete thyroid function evaluation. JAMA 1981; 245:1919-1922

3. Prange AJ, Haggerty JJ, Browne JL, Rice JD: Marginal hypothyroidism in mental illness: preliminary assessments of prevalence and significance, in Neuropsychopharmacology. Edited by Bunney WE Jr, Hippius H, Laakmann G, Schmauss M. New York, Springer-Verlag, 1990

4. Haggerty JJ Jr, Simon JS, Evans DL, Nemeroff CB: Relationship of serum TSH concentration and antithyroid antibodies to diag-
nosis and DST response in psychiatric inpatients. Am J Psychiatry 1987; 144:1491-1493

5. Tunbridge WM, Brewis M, French JM, Appleton D, Bird T, Clark F, Evered DC, Evans JG, Hall R, Smith P, Stephenson J, Young E: Natural history of autoimmune thyroiditis. Br Med J 1981; 282:258-262

6. Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia-Lifetime Version, 3rd ed. New York, New York Psychiatric Institute, Biometrics Research, 1979

7. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35:773-782

8. Garbutt JC, Mayo JP Jr, Mason GA, Quade D, Loosen PT, Prange AJ Jr: Interpretation of the thyrotropin (TSH) response to thyrotropin releasing hormone (TRH): implications of an improved TSH assay system. Biol Psychiatry 1991; 29:718-720

9. Targum SD, Greenberg RD, Harmon RL, Kessler K, Salerian AJ, Fram DH: Thyroid hormone and the TRH stimulation test in refractory depression. J Clin Psychiatry 1984; 45:345-346

10. Goodnick PJ, Extein IL, Gold MS: TRH test in the treatment of depression, in New Research Program and Abstracts, 143rd Annual Meeting of the American Psychiatric Association. Washing-ton, DC, APA, 1989