Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
J Affect Disord. 2019 Dec 1;259:180-185. doi: 10.1016/j.jad.2019.08.067. Epub 2019 Aug 20.
Thyroid dysfunction was reported to be associated with depression; however, its role in suicide risk in patients with major depressive disorder (MDD) remains unclear. The objective of this study was to compare thyroid function between suicide attempters and non-suicide attempters in a large sample of first episode drug naïve (FEDN) MDD patients, which received little systemic investigation.
A total of 1718 outpatients with diagnosis of MDD at their first episode were recruited. Their socio-demographic, clinical data and thyroid function parameters were collected. The positive subscale of the Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were measured for psychotic, anxiety and depressive symptoms, respectively.
Our results showed that compared with non-suicide attempters, suicide attempters had greater scores on HAMD, HAMA and PANSS psychotic symptoms and higher serum levels in thyroid stimulating hormone (TSH), anti-thyroglobulin (TgAb) and thyroid peroxidases antibody (TPOAb) (all p < 0.001). Further logistic regression analysis indicated that suicide attempts were associated with severe anxiety with an adjusted odds ratio (OR) of 2.704 and TPOAb with an adjusted OR of 2.188.
No causal relationship could be drawn due to the cross-sectional design.
Our results indicate TSH, TgAb and TPOAb may be promising biomarkers of suicide risk in MDD, suggesting the importance of regular assessment of thyroid function parameters for suicide prevention, and possible treatment for impaired thyroid function for intervention of suicide in MDD patients.
甲状腺功能障碍与抑郁症有关；然而，其在重度抑郁症（MDD）患者自杀风险中的作用仍不清楚。本研究的目的是在一个接受系统研究较少的大样本初发未经药物治疗（FEDN）MDD 患者中比较自杀未遂者和非自杀未遂者的甲状腺功能。
共招募了 1718 名首次发作 MDD 的门诊患者。收集了他们的社会人口统计学、临床数据和甲状腺功能参数。阳性和阴性症状量表（PANSS）的阳性子量表、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）分别用于评估精神病、焦虑和抑郁症状。
我们的结果表明，与非自杀未遂者相比，自杀未遂者的 HAMD、HAMA 和 PANSS 精神病症状评分更高，促甲状腺激素（TSH）、抗甲状腺球蛋白（TgAb）和甲状腺过氧化物酶抗体（TPOAb）血清水平更高（均 p < 0.001）。进一步的逻辑回归分析表明，严重焦虑与自杀企图相关，调整后的优势比（OR）为 2.704，TPOAb 为 2.188。
由于横断面设计，无法得出因果关系。
我们的结果表明 TSH、TgAb 和 TPOAb 可能是 MDD 自杀风险的有前途的生物标志物，提示定期评估甲状腺功能参数对预防自杀的重要性，以及对受损甲状腺功能的可能治疗对 MDD 患者自杀的干预作用。
