Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Université Libre de Bruxelles, Bruxelles, Belgium; Psy Pluriel Centre Européen de Psychologie Médicale, Bruxelles, Belgium.
Eur Neuropsychopharmacol. 2018 Jun;28(6):752-760. doi: 10.1016/j.euroneuro.2018.03.011. Epub 2018 Apr 26.
This multicenter study of the European Group for the Study of Resistant Depression (GSRD) aimed to explore the association between major depressive disorder (MDD) and comorbid thyroid disease. A total number of 1410 patients` characteristics in terms of demographic and clinical information were compared between MDD subjects with and without concurrent thyroid disease using descriptive statistics, analyses of covariance (ANCOVA) and binary logistic regression analyses. We determined a point prevalence rate for comorbid hypothyroidism of 13.2% and 1.6% for comorbid hyperthyroidism respectively. Patients with MDD+comorbid hypothyroidism were significantly older, more likely to be female, inpatient and suffering from other comorbid chronic somatic conditions. Furthermore, MADRS score at onset of the current depressive episode was significantly higher, psychotic features of depression were more likely pronounced. Overall, patients in the MDD+comorbid hypothyroidism group were rather treated with a combination of drugs, for example, pregabalin, antipsychotic drugs and mood stabilizers. In the MDD+comorbid hyperthyroidism group patients were significantly older, of Caucasian origin and diagnosed with other somatic comorbidities. In conclusion, our analyses suggest that abnormal thyroid function, especially hypothyroidism, is linked to depression severity and associated with distinct psychopathologic features of depression. However, comorbid thyroid disease has no influence on treatment response. A combination or augmentation of psychopharmacological drugs, especially with antipsychotics, mood stabilizers and pregabalin is more likely in patients with hypothyroid conditions. Thyroid disorder is frequently found in combination with other chronic somatic diseases including hypertension and heart disease.
这项由欧洲耐药性抑郁症研究组（GSRD）开展的多中心研究旨在探讨重度抑郁症（MDD）与合并甲状腺疾病之间的关系。采用描述性统计、协方差分析（ANCOVA）和二项逻辑回归分析比较了 MDD 患者中伴有和不伴有合并甲状腺疾病的患者的人口统计学和临床信息特征。我们确定合并甲状腺功能减退症的患病率为 13.2%，合并甲状腺功能亢进症的患病率为 1.6%。患有 MDD+合并甲状腺功能减退症的患者年龄明显较大，女性、住院和患有其他合并慢性躯体疾病的可能性更高。此外，当前抑郁发作时 MADRS 评分明显更高，抑郁的精神病特征更有可能明显。总的来说，MDD+合并甲状腺功能减退症组的患者更倾向于联合使用药物治疗，例如普瑞巴林、抗精神病药物和心境稳定剂。在 MDD+合并甲状腺功能亢进症组中，患者年龄明显较大，来自白种人，且被诊断为患有其他躯体合并症。总之，我们的分析表明，甲状腺功能异常，尤其是甲状腺功能减退，与抑郁严重程度有关，并与抑郁的特定精神病理特征相关。然而，合并甲状腺疾病对治疗反应没有影响。在甲状腺功能减退症患者中，更可能联合或增强使用精神药物，尤其是抗精神病药物、心境稳定剂和普瑞巴林。甲状腺疾病常与高血压和心脏病等其他慢性躯体疾病合并存在。
