Carta Mauro Giovanni, Loviselli Andrea, Hardoy Maria Carolina, Massa Sergio, Cadeddu Mariangela, Sardu Claudia, Carpiniello Bernardo, Dell'Osso Liliana, Mariotti Stefano
Department of Public Health, Division of Psychiatry, University of Cagliari, Italy.
BMC Psychiatry. 2004 Aug 18;4:25. doi: 10.1186/1471-244X-4-25.
To evaluate the association between mood and anxiety disorders and thyroid autoimmunity in a community sample.
A community based sample of 222 subjects was examined. Psychiatric diagnoses were formulated using the International Composite Diagnostic Interview Simplified (CIDIS), according to DSM-IV criteria. All subjects underwent a complete thyroid evaluation including physical examination, thyroid echography and measure of serum free T4 (FT4), free T3 (FT3), thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase autoantibodies (anti-TPO).
16.6% of the overall sample had an anti-TPO value above the normal cut-off. Subjects with at least one diagnosis of anxiety disorders (OR = 4.2, C.L. 95% 1.9-38.8) or mood disorders (OR = 2.9, Cl 95% 1.4-6.6, P < 0.011) were positive for serum anti-TPO more frequently than subjects without mood or anxiety disorders. A statistically significant association with anti-TPO+ was found in Anxiety Disorder Not Otherwise Specified (OR = 4.0, CL 95% 1.1-15.5), in Major Depressive Episode (OR = 2.7, CL 95% 1.1-6.7) and Depressive Disorder Not Otherwise Specified (OR = 4.4, S CL 95% 1-19.3).
The study seems to suggest that individuals in the community with thyroid autoimmunity may be at high risk for mood and anxiety disorders. The psychiatric disorders and the autoimmune reaction seem to be rooted in a same (and not easy correctable) aberrancy in the immuno-endocrine system. Should our results be confirmed, the findings may be of great interest for future preventive and case finding projects.
评估社区样本中情绪和焦虑障碍与甲状腺自身免疫之间的关联。
对222名受试者的社区样本进行检查。根据DSM-IV标准,使用国际综合诊断访谈简化版(CIDIS)进行精神疾病诊断。所有受试者均接受了完整的甲状腺评估,包括体格检查、甲状腺超声检查以及血清游离T4(FT4)、游离T3(FT3)、促甲状腺激素(TSH)和抗甲状腺过氧化物酶自身抗体(抗-TPO)的检测。
总体样本中16.6%的受试者抗-TPO值高于正常临界值。至少有一次焦虑障碍诊断(OR = 4.2,95%置信区间1.9 - 38.8)或情绪障碍诊断(OR = 2.9,95%置信区间1.4 - 6.6,P < 0.011)的受试者血清抗-TPO呈阳性的频率高于无情绪或焦虑障碍的受试者。在未另行说明的焦虑障碍(OR = 4.0,95%置信区间1.1 - 15.5)、重度抑郁发作(OR = 2.7,95%置信区间1.1 - 6.7)和未另行说明的抑郁障碍(OR = 4.4,95%置信区间1 - 19.3)中发现与抗-TPO阳性存在统计学显著关联。
该研究似乎表明,社区中患有甲状腺自身免疫的个体可能患情绪和焦虑障碍的风险较高。精神疾病和自身免疫反应似乎源于免疫内分泌系统中相同的(且不易纠正的)异常。如果我们的结果得到证实,这些发现可能对未来预防和病例发现项目具有重要意义。