Department of Child and Adolescent Psychiatry, RWTH University of Aachen, Germany.
J Affect Disord. 2011 Nov;134(1-3):478-82. doi: 10.1016/j.jad.2011.05.040. Epub 2011 Jun 28.
Evidence from adults suggests that changes in thyroid function are associated with the development of bipolar disorder (BD) and severe mood dysregulation. A dysregulation profile based on the Child Behavior Checklist (CBCL-DP) describes a phenotype with severe mood problems in youth. The present study investigated whether altered thyroid functioning in youths is associated with the severe mood dysregulation symptoms characterized by the CBCL-DP.
We analyzed the thyroid function data from 262 children and adolescents (n = 262 for serum TSH, n = 148 for free triiodothyronine [fT3] and n = 153 for free thyroxine [fT4]) with their CBCL-DP composite score. We created and compared high CBCL-DP and low CBCL-DP subgroups with regard to their serum TSH, fT3 and fT4 concentrations as well as the presence or absence of subclinical hypothyroidism.
We did not detect between-group differences in serum TSH, fT3 and fT4 concentrations, nor were there significant correlations between youths' CBCL-DP scores and their serum TSH, fT3 and fT4 concentrations for either the whole sample or any subgroup. Post-hoc power analyses indicated that adequate to moderate power existed to detect between-group differences in fT3 and fT4 concentrations, respectively, but that larger TSH samples would be required to detect the same differences in those concentrations.
This study had a retrospective design, fewer females than males, and reduced power with respect to TSH concentrations.
The present investigation does not support the association between elevated serum-TSH concentrations and severe mood dysregulation in youths. However, these findings should be confirmed in future large-scale studies.
成年人的研究证据表明，甲状腺功能的变化与双相障碍（BD）和严重情绪失调的发展有关。基于儿童行为检查表（CBCL-DP）的失调特征描述了一种在青少年中具有严重情绪问题的表型。本研究调查了青少年甲状腺功能的改变是否与 CBCL-DP 所描述的严重情绪失调症状有关。
我们分析了 262 名儿童和青少年（n=262 例血清 TSH，n=148 例游离三碘甲状腺原氨酸 [fT3]，n=153 例游离甲状腺素 [fT4]）的甲状腺功能数据及其 CBCL-DP 综合评分。我们创建了高 CBCL-DP 和低 CBCL-DP 亚组，并比较了它们的血清 TSH、fT3 和 fT4 浓度，以及亚临床甲状腺功能减退的存在与否。
我们没有发现血清 TSH、fT3 和 fT4 浓度在两组之间存在差异，也没有发现青少年 CBCL-DP 评分与他们的血清 TSH、fT3 和 fT4 浓度之间存在显著相关性，无论是整个样本还是任何亚组。事后功效分析表明，分别检测 fT3 和 fT4 浓度的组间差异存在足够到中度的功效，但需要更大的 TSH 样本才能检测到这些浓度的相同差异。
本研究采用回顾性设计，女性人数少于男性，TSH 浓度的功效降低。
本研究不支持血清 TSH 浓度升高与青少年严重情绪失调之间的关联。然而，这些发现应在未来的大规模研究中得到证实。
