Wang Xue, Luo Jiong, Yuan Xiao-Fei, Chen Xu, Yu Hong-Ye, Zhu Xue-Quan, Wang Gang
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Asian J Psychiatr. 2022 May;71:103086. doi: 10.1016/j.ajp.2022.103086. Epub 2022 Mar 14.
To examine whether thyroid function in the normal range is associated with recurrence of depressive or mania in bipolar disorder patients.
104 patients with bipolar disorder in maintenance therapy phase were assigned randomly to mood stabilizer combined with antidepressant group or mood stabilizer group. There were 52 patients in both groups respectively. Clinical symptoms were assessed at baseline, 3rd month, 6th month, 9th month, and 12th month using HAMD-17 and YMRS. Blood samples were analyzed for thyroid function.
There was no statistically significant difference of recurrence rate of depressive episode and mania episode at the end of the 12-months between mood stabilizer combined with antidepressant group and mood stabilizer group. There was significant relation of baseline TT4 (P = 0.020, HR = 0.948), FT3 (P = 0.035, HR = 2.055), and FT4 (P = 0.047, OR=0.769) with the recurrence of depressive episode in mood stabilizer group. The area under curve (AUC) of TT4, FT3, FT4 were 0.685, 0.613, 0.544, respectively. There was significant relation of baseline FT3 (P = 0.044，HR = 4.493) with the recurrence of mania episode for mood stabilizer combined with antidepressants group. The AUC of FT3 was 0.806.
Low level of TT4, FT4 and high level of FT3 within normal-range were related with the recurrence of depressive episode in the maintenance treatment with mood stabilizer of bipolar disorder. High level of FT3 within normal-range were related with recurrence of mania when mood stabilizer combined with antidepressants were used in the maintenance treatment of bipolar disorder.
探讨甲状腺功能处于正常范围是否与双相情感障碍患者抑郁或躁狂复发有关。
将104例处于维持治疗阶段的双相情感障碍患者随机分为心境稳定剂联合抗抑郁药组和心境稳定剂组，每组各52例。在基线、第3个月、第6个月、第9个月和第12个月时，使用汉密尔顿抑郁量表17项版（HAMD - 17）和杨氏躁狂量表（YMRS）评估临床症状。分析血样中的甲状腺功能。
心境稳定剂联合抗抑郁药组与心境稳定剂组在12个月结束时，抑郁发作和躁狂发作的复发率无统计学显著差异。在心境稳定剂组中，基线总甲状腺素（TT4）（P = 0.020，风险比[HR] = 0.948）、游离三碘甲状腺原氨酸（FT3）（P = 0.035，HR = 2.055）和游离甲状腺素（FT4）（P = 0.047，比值比[OR]=0.769）与抑郁发作复发有显著相关性。TT4、FT3、FT4的曲线下面积（AUC）分别为0.685、0.613、0.544。在心境稳定剂联合抗抑郁药组中，基线FT3（P = 0.044，HR = 4.493）与躁狂发作复发有显著相关性。FT3的AUC为0.806。
在双相情感障碍心境稳定剂维持治疗中，正常范围内低水平的TT4、FT4以及高水平的FT3与抑郁发作复发有关。在双相情感障碍维持治疗中使用心境稳定剂联合抗抑郁药时，正常范围内高水平的FT3与躁狂复发有关。
