Andrade Junior Nelson Elias, Pires Maria Lúcia Elias, Thuler Luiz Claudio Santos
Universidade Federal do Estado do Rio de Janeiro, RJ, Brasil.
Rev Bras Ginecol Obstet. 2010 Jul;32(7):321-6. doi: 10.1590/s0100-72032010000700003.
To study the association between hypothyroidism and depression and anxiety symptoms.
A case-control study was carried out from July 2006 to March 2008 on 100 patients (50 patients with primary hypothyroidism and 50 euthyroid controls) aged 18 to 65 years. Age, race/skin color, marital status, education level, alcohol use, working status, body mass index and menopausal status were evaluated. TSH levels were determined and the Beck Depression and Beck Anxiety Scales were applied to all cases and controls. Statistical analysis was performed using the SPSS software version 14.0. The level of significance was set at p<0.05.
There was no demographic or epidemiologic difference between groups. The concomitant presence of anxiety and depression was five times greater among cases than among controls (20.0 versus 4.0%, p=0.01). Anxiety symptoms were approximately three times more frequent among cases (40.0%) than among controls (14.0%) (p=0.003), while the prevalence of depressive symptoms was 75% higher among cases (28.0%) than among controls (16.0%), but this did not reach statistical significance (p=0.15). We found no association between TSH levels and the prevalence of anxiety or depression symptoms.
This case-control study showed a greater probability for hypothyroid patients to develop anxiety and depression symptoms when compared to euthyroid controls. Due to the high prevalence of hypothyroidism and depression observed in clinical practice, depressive symptoms must be considered in patients with thyroid dysfunction and depressed patients should be tested for TSH.
研究甲状腺功能减退与抑郁及焦虑症状之间的关联。
于2006年7月至2008年3月对100例年龄在18至65岁之间的患者进行了一项病例对照研究(50例原发性甲状腺功能减退患者和50例甲状腺功能正常的对照者)。评估了年龄、种族/肤色、婚姻状况、教育水平、饮酒情况、工作状态、体重指数和绝经状态。测定了促甲状腺激素(TSH)水平,并对所有病例和对照者应用了贝克抑郁量表和贝克焦虑量表。使用SPSS 14.0软件进行统计分析。显著性水平设定为p<0.05。
两组之间在人口统计学或流行病学方面无差异。病例组中焦虑和抑郁同时存在的情况是对照组的五倍(20.0%对4.0%,p = 0.01)。病例组中焦虑症状的出现频率约为对照组的三倍(40.0%对14.0%)(p = 0.003),而抑郁症状的患病率在病例组中比对照组高75%(28.0%对16.0%),但这未达到统计学显著性(p = 0.15)。我们未发现TSH水平与焦虑或抑郁症状的患病率之间存在关联。
这项病例对照研究表明,与甲状腺功能正常的对照者相比,甲状腺功能减退患者出现焦虑和抑郁症状的可能性更大。鉴于在临床实践中观察到甲状腺功能减退和抑郁的高患病率,对于甲状腺功能障碍患者必须考虑抑郁症状,而对于抑郁患者应检测TSH。