Fountoulakis Konstantinos N, Iacovides Apostolos, Grammaticos Philippos, St Kaprinis George, Bech Per
Laboratory of Psychophysiology, 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University Hospital AHEPA, Thessaloniki, Greece.
BMC Psychiatry. 2004 Mar 15;4:6. doi: 10.1186/1471-244X-4-6.
Unipolar depression might be characterized by a 'low-thyroid function syndrome'. To our knowledge, this is the first study which explores the possible relationship of DSM-IV depressive subtypes and the medium term outcome, with thyroid function.
Thirty major depressive patients (DSM-IV) aged 21-60 years and 60 control subjects were included. Clinical Diagnosis: The SCAN v 2.0 and the IPDE were used. The psychometric Assessment included HDRS the HAS and the GAF scales. Free-T3, Free-T4, TSH, Thyroid Binding Inhibitory Immunoglobulins (TBII), Thyroglobulin antibodies (TA) and Thyroid Microsomal Antibodies (TMA) were measured in the serum. The Statistical analysis included 1 and 2-way MANCOVA, discriminant function analysis and Pearson Product Moment Correlation Coefficient.
All depressive subtypes had significantly higher TBII levels in comparison to controls. Atypical patients had significantly higher TMA in comparison to controls. No significant correlation was observed between the HDRS, HAS and GAF scales and thyroid indices. Discriminant function analysis produced functions based on thyroid indices, which could moderately discriminate between diagnostic groups, but could predict good response to treatment with 89.47% chance of success.
Although overt thyroid dysfunction is not common in depression, there is evidence suggesting the presence of an autoimmune process affecting the thyroid gland in depressive patients
单相抑郁症可能具有“低甲状腺功能综合征”的特征。据我们所知,这是第一项探讨DSM-IV抑郁亚型与中期预后以及甲状腺功能之间可能关系的研究。
纳入了30名年龄在21至60岁之间的重度抑郁患者(DSM-IV)和60名对照受试者。临床诊断:使用了SCAN v 2.0和IPDE。心理测量评估包括汉密尔顿抑郁量表(HDRS)、医院焦虑抑郁量表(HAS)和大体功能评定量表(GAF)。测定血清中的游离T3、游离T4、促甲状腺激素(TSH)、甲状腺结合抑制性免疫球蛋白(TBII)、甲状腺球蛋白抗体(TA)和甲状腺微粒体抗体(TMA)。统计分析包括单因素和双因素多变量协方差分析、判别函数分析以及皮尔逊积矩相关系数分析。
与对照组相比,所有抑郁亚型的TBII水平均显著更高。非典型患者的TMA水平与对照组相比显著更高。未观察到HDRS、HAS和GAF量表与甲状腺指标之间存在显著相关性。判别函数分析基于甲状腺指标生成了函数,这些函数可以适度区分诊断组,但能够以89.47%的成功几率预测对治疗的良好反应。
尽管明显的甲状腺功能障碍在抑郁症中并不常见,但有证据表明抑郁症患者存在影响甲状腺的自身免疫过程。