Department of Psychiatry, San Paolo Hospital, University of Milan, Milan, Italy.
Panminerva Med. 2010 Dec;52(4):277-82.
The aim of this study was to estimate the prevalence of depressive symptoms in patients affected by subclinical hypothyroidism by means of Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS); to assess which depressive symptoms are prevalent in our population, with references to the factorialization of HAM-D by Cleary and Guy (1977); to verify whether levothyroxine replacement therapy alone can induce total remission of depressive symptoms.
The study enrolled 63 patients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology service of San Paolo Hospital in Milan. All patients underwent an evaluation by means of HAM-D and MADRS scales and serum TSH, free T4, free T3, TPO-Ab and Tg-Ab levels were measured.
We estimated a prevalence of depressive symptoms in our population of 63.5%. Concerning the qualitative assessment of psychiatric disturbances in the population we considered, our results showed that the most frequent symptoms were part of four factors, according to the Cleary and Guy factorialization of HAM-D: these factors are representative of anxiety and somatisation (factor I), cognitive impairment disturbances (factor III), psychomotor retardation (factor V) and sleep disorders (factor VI). Levothyroxine replacement therapy alone wasn't effective in inducing total remission of depressive symptoms.
This study suggests the importance of a psychiatric evaluation in patients affected by subclinical hypothyroidism.
本研究旨在通过汉密尔顿抑郁量表（HAM-D）和蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评估亚临床甲状腺功能减退症患者抑郁症状的患病率；评估我们人群中哪些抑郁症状较为普遍，并参考 Cleary 和 Guy（1977 年）对 HAM-D 的因子化；验证单独使用左甲状腺素替代疗法是否能诱导抑郁症状完全缓解。
本研究纳入了在米兰圣保禄医院内分泌科接受随访的 63 例亚临床甲状腺功能减退症患者。所有患者均接受 HAM-D 和 MADRS 量表评估，并检测血清 TSH、游离 T4、游离 T3、TPO-Ab 和 Tg-Ab 水平。
我们估计我们人群中抑郁症状的患病率为 63.5%。关于我们所考虑的人群中精神障碍的定性评估，我们的结果表明，最常见的症状属于 HAM-D 的 Cleary 和 Guy 因子化的四个因子：这些因子代表焦虑和躯体化（因子 I）、认知障碍（因子 III）、精神运动迟缓（因子 V）和睡眠障碍（因子 VI）。单独使用左甲状腺素替代疗法并不能有效诱导抑郁症状完全缓解。
本研究提示在亚临床甲状腺功能减退症患者中进行精神评估的重要性。
