Martiny Klaus, Simonsen Christian, Lunde Marianne, Clemmensen Lars, Bech Per
Psychiatric Research Unit, Frederiksborg General Hospital, Dyrehavevej 48, DK-3400 Hillerød, Denmark.
J Affect Disord. 2004 Apr;79(1-3):253-7. doi: 10.1016/S0165-0327(02)00361-0.
Seasonal Affective Disorder (SAD) is characterised by lowered mood and atypical depressive symptoms such as hypersomnia, weight gain and fatigue. These symptoms seem associated with hypothyroidism, but the results of evaluations of the thyroid function in SAD patients have been conflicting, most likely due to the very small number of observations.
In total, 83 patients fulfilling the DSM-III-R criteria for SAD were treated with bright light for 1 week in an open trial. Thyroid function was evaluated by TSH (thyroid-stimulating hormone), T(4) (thyroxine) and T(3) (triiodthyronine) levels at baseline and after 1 week of bright light treatment.
The response rate in terms of a 50% reduction of pre-treatment scores on the Hamilton Depressions Rating Scale (HAM-D(17)) was 61%. The TSH levels in all 83 patients decreased significantly from 1.57 at baseline to 1.30 at endpoint. In the group of responders (n=52) the TSH levels decreased significantly from 1.71 to 1.37, while in the group of non-responders (n=31) the decrease in TSH levels was not statistically significant.
During 1 week of bright light therapy the TSH levels in SAD patients were reduced, with the highest reduction in the group of patients responding to light therapy.
季节性情感障碍(SAD)的特征是情绪低落以及出现如嗜睡、体重增加和疲劳等非典型抑郁症状。这些症状似乎与甲状腺功能减退有关,但对SAD患者甲状腺功能评估的结果一直存在矛盾,很可能是因为观察数量极少。
在一项开放试验中,总共83名符合DSM-III-R标准的SAD患者接受了为期1周的强光治疗。在基线和强光治疗1周后,通过促甲状腺激素(TSH)、甲状腺素(T4)和三碘甲状腺原氨酸(T3)水平评估甲状腺功能。
汉密尔顿抑郁评定量表(HAM-D(17))治疗前评分降低50%的缓解率为61%。所有83名患者的TSH水平从基线时的1.57显著降至终点时的1.30。在缓解组(n = 52)中,TSH水平从1.71显著降至1.37,而在未缓解组(n = 31)中,TSH水平的降低无统计学意义。
在1周的强光治疗期间,SAD患者的TSH水平降低,其中对光疗有反应的患者组降低最为明显。