Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Pharmacy, Peking University Third Hospital, Beijing, China.
BMC Psychiatry. 2023 Aug 18;23(1):603. doi: 10.1186/s12888-023-05089-w.
Gender differences in patients with major depressive disorder (MDD) are commonly reported; however, gender differences in first-episode and drug-naïve (FEDN) MDD patients with comorbid suicide attempts have not been reported. This study aimed to examine potential gender differences in the prevalence and clinical correlates of comorbid abnormal thyroid function (ATF) in FEDN MDD patients with comorbid suicide attempts.
A cross-sectional study of 1718 FEDN MDD patients was conducted. The demographic and clinical data were collected. The Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) were used to assess depression, anxiety and psychotic symptoms, respectively. Thyroid function parameters and blood glucose levels were measured.
There was no gender difference in the prevalence of ATF between male (78.6%, 88/112) and female MDD patients (74.8%, 175/234) with comorbid suicide attempts. In the male and female subgroups, duration of disease, HAMD score, HAMA score, anti-thyroglobulin (TgAb), thyroid peroxidases antibody (TPOAb), diastolic blood pressure (DBP), systolic blood pressure (SBP), glucose level and the rate of psychotic symptoms were higher in patients with ATF than those without ATF in MDD with comorbid suicide attempt (all P < 0.05). There was a gender main effect only on SBP (F = 7.35, P = 0.007). Furthermore, binary logistic regression analysis showed that HAMD score, DBP and glucose levels were independently with ATF in both male and female MDD patients with comorbid suicide attempts. However, anxiety symptoms, psychotic symptoms and TPOAb levels were significantly associated with ATF only in female MDD patients with comorbid suicide attempts.
Our study showed no gender differences in the prevalence of ATF in FEDN MDD patients with comorbid suicide attempts. Depression, DBP and glucose levels were associated with ATF in both male and female MDD patients with comorbid suicide attempts, whereas anxiety, psychotic symptoms and TPOAb level were correlated with ATF only in female MDD patients with suicide attempts.
重度抑郁症（MDD）患者的性别差异较为常见，但伴有自杀未遂的首发、未用药（FEDN）MDD 患者的性别差异尚未报道。本研究旨在研究伴有自杀未遂的 FEDN MDD 患者中，并存异常甲状腺功能（ATF）的发生率和临床相关性是否存在潜在的性别差异。
对 1718 例 FEDN MDD 患者进行横断面研究。收集人口统计学和临床数据。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和阳性和阴性综合征量表（PANSS）评估抑郁、焦虑和精神病症状。检测甲状腺功能参数和血糖水平。
伴有自杀未遂的男性（78.6%，88/112）和女性 MDD 患者（74.8%，175/234）中 ATF 的发生率无性别差异。在男性和女性亚组中，疾病持续时间、HAMD 评分、HAMA 评分、抗甲状腺球蛋白（TgAb）、甲状腺过氧化物酶抗体（TPOAb）、舒张压（DBP）、收缩压（SBP）、血糖水平和精神病症状发生率在伴有自杀未遂的 MDD 合并 ATF 的患者中均高于无 ATF 的患者（均 P<0.05）。仅 SBP 存在性别主效应（F=7.35，P=0.007）。此外，二元逻辑回归分析显示，HAMD 评分、DBP 和血糖水平与伴有自杀未遂的男女 MDD 患者的 ATF 独立相关。然而，焦虑症状、精神病症状和 TPOAb 水平仅与伴有自杀未遂的女性 MDD 患者的 ATF 显著相关。
本研究显示，伴有自杀未遂的 FEDN MDD 患者中 ATF 的发生率无性别差异。抑郁、DBP 和血糖水平与伴有自杀未遂的男女 MDD 患者的 ATF 相关，而焦虑、精神病症状和 TPOAb 水平仅与伴有自杀未遂的女性 MDD 患者的 ATF 相关。
