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首发且未用药的年轻重度抑郁症患者中焦虑症状与甲状腺激素之间关联的性别差异。

Gender differences in the association between anxiety symptoms and thyroid hormones in young patients with first-episode and drug naïve major depressive disorder.

作者信息

Zhao Ying, Liu Jia Cheng, Yu Feng, Yang Li Ying, Kang Chuan Yi, Yan Li Juan, Liu Si Tong, Zhao Na, Wang Xiao Hong, Zhang Xiang Yang

机构信息

The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.

First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.

出版信息

Front Psychiatry. 2023 Aug 29;14:1218551. doi: 10.3389/fpsyt.2023.1218551. eCollection 2023.

Abstract

OBJECTIVE

Gender differences are prevalent in major depressive disorder (MDD), but the gender differences in the relationship between comorbid anxiety and thyroid hormones in young first-episode and drug-naive (FEND) MDD patients are unknown.

METHODS

A total of 1,289 young outpatients with FEDN MDD were recruited. Demographic and clinical data were collected for each patient. The patient's blood glucose, blood pressure, thyroid hormone, and thyroid antibody levels were measured. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess patients' depression, anxiety, and positive symptoms, respectively.

RESULTS

The prevalence of comorbid anxiety disorders was 80.4 and 79.4% in male and female MDD patients, respectively. Patients with anxiety had higher HAMD and PANSS scores, higher serum thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (A-TG), and thyroid peroxidase antibody (A-TPO) levels, higher blood glucose and blood pressure levels, and more patients with psychotic symptoms and suicide attempts. Male patients were younger and had a younger age of onset. Logistic regression analysis showed that HAMD score and comorbid suicide attempts were significant predictors of anxiety symptoms in both males and females, whereas A-TG predicted anxiety symptoms in female patients only. Limitations: No causal relationship could be drawn due to the cross-sectional design.

CONCLUSION

This study showed gender differences in factors associated with anxiety symptoms in patients with MDD. Some factors were associated with anxiety symptoms in both male and female patients, while A-TG was only associated with anxiety symptoms in female patients.

摘要

目的

性别差异在重度抑郁症(MDD)中普遍存在,但首次发作且未服用过药物的年轻MDD患者中,共病焦虑与甲状腺激素之间关系的性别差异尚不清楚。

方法

共招募了1289名首次发作且未服用过药物的年轻MDD门诊患者。收集每位患者的人口统计学和临床数据。测量患者的血糖、血压、甲状腺激素和甲状腺抗体水平。分别使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和阳性与阴性症状量表(PANSS)评估患者的抑郁、焦虑和阳性症状。

结果

男性和女性MDD患者中共病焦虑障碍的患病率分别为80.4%和79.4%。有焦虑症状的患者HAMD和PANSS评分更高,血清促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(A-TG)和甲状腺过氧化物酶抗体(A-TPO)水平更高,血糖和血压水平更高,有精神病性症状和自杀企图的患者更多。男性患者年龄更小且起病年龄更年轻。逻辑回归分析表明,HAMD评分和共病自杀企图是男性和女性焦虑症状的显著预测因素,而A-TG仅预测女性患者的焦虑症状。局限性:由于采用横断面设计,无法得出因果关系。

结论

本研究显示了MDD患者中与焦虑症状相关因素的性别差异。一些因素在男性和女性患者中均与焦虑症状相关,而A-TG仅与女性患者的焦虑症状相关。

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