Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
BMC Endocr Disord. 2021 Oct 21;21(1):210. doi: 10.1186/s12902-021-00869-5.
Previous studies have shown that bipolar disorder is closely related to thyroid dysfunction. Psychiatric drugs have a large or small effect on thyroid function, and thyroid hormone levels can also affect the effect of drug treatment. Therefore, the purpose of this study is assessment the thyroid function of drug-naive bipolar disorder across different mood states, with the expectation of providing support for treatment options.
The present study is a cross-sectional study. Patients diagnosed with bipolar disorder according to the International Classification of Diseases diagnostic Criteria, Edition 10 (ICD 10) and who had never received medication were included in the study. The Montgomery Depression Scale (MADRS) was used to assess depressive symptoms and the Young Mania Rating Scale (YMRS) for manic symptoms. Thyroid function indicators include thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), and total thyroxine (TT4). Levels of TSH, TT4, FT4, TT3, and FT3 were measured within 48 h of hospitalization, between 06:00 and 08:00.
The data analysis finally covered the data of 291 subjects (136 in a bipolar manic group, 128 in a bipolar depressive group, and 27 in a bipolar mixed group), including 140 males and 151 females, with an average age of 27.38 ± 8.01. There was no significant difference in age, sex, marital status, work status, family history, and course of illness among the manic group, depressive group, and mixed group. The level of FT3, the rate of thyroid hormone increased secretion, and the total abnormality rate of thyroid hormone secretion in the manic group were significantly higher than those in the depressive group.
These findings indicate that thyroid functions were significantly different between depressive and manic episodes in BD patients. In clinical practice, it is necessary to take into account the differences in thyroid hormone levels in patients with BD across different emotional states in choosing drug.
既往研究表明，双相障碍与甲状腺功能障碍密切相关。精神科药物对甲状腺功能的影响有大有小，而甲状腺激素水平也会影响药物治疗效果。因此，本研究旨在评估不同心境状态下未经药物治疗的双相障碍患者的甲状腺功能，以期为治疗方案提供支持。
本研究为横断面研究。纳入根据国际疾病分类第 10 版（ICD-10）诊断为双相障碍且从未接受过药物治疗的患者。采用蒙哥马利抑郁评定量表（MADRS）评估抑郁症状，Young 躁狂评定量表（YMRS）评估躁狂症状。甲状腺功能指标包括促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、总三碘甲状腺原氨酸（TT3）、游离甲状腺素（FT4）和总甲状腺素（TT4）。入院后 48 小时内，于 06:00 至 08:00 之间测定 TSH、TT4、FT4、TT3 和 FT3 水平。
数据分析最终涵盖了 291 例患者的数据（136 例双相躁狂组、128 例双相抑郁组和 27 例双相混合组），包括 140 例男性和 151 例女性，平均年龄为 27.38±8.01。躁狂组、抑郁组和混合组在年龄、性别、婚姻状况、工作状况、家族史和病程方面差异均无统计学意义。躁狂组 FT3 水平、甲状腺激素高分泌率和甲状腺激素总分泌异常率显著高于抑郁组。
这些发现表明，BD 患者在抑郁和躁狂发作时甲状腺功能存在显著差异。在临床实践中，在选择药物时，需要考虑到 BD 患者在不同情绪状态下甲状腺激素水平的差异。
