Title: Depression in Hypothyroidism and Risk Factors
Authors: Dr Mohammed Naseem .Y. MD, Dr C. Jayakumari MD, Dr Abilash Nair, DM, Dr Aswini Kumar S. MD, Dr Saboora Beegum M, MD
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.182
Abstract
Background: There are limited studies on depression in medically ill using current diagnostic tools in India. The present study aims to find the prevalence of depression in patients with hypothyroidism and its association with clinical parameters and thyroid autoantibody levels.
Materials and Methods: Patients fulfilling clinical and biochemical criteria suggesting hypothyroidism of either gender or age between18 and 65 years were included in the study. Clinical features and serum TSH were noted, Anti TPO antibody test was done. Patients were administered the validated local language version of the Hospital anxiety and depression score (HADS). Patients were classified as normal, those with borderline depression and those with depression.
Results and Discussion: One hundred and forty four patients were included in the analysis. Eighteen out of 144 patients had depression and another 20 had borderline depression. Higher serum thyroid stimulating hormone, anti-thyroid peroxidase antibody levels and body mass index were found to have a significant relation to presence of depression. The independent association of TPO antibody to depression when adjusted for TSH could not be proven. Symptoms such as, cold intolerance, memory loss and clinical assessments like BMI as an association to depression in hypothyroid patients is a novel finding when compared to older studies.
Conclusion: There is a high prevalence of depression in patients with hypothyroidism which can be diagnosed only if systematic screening using validated tools is used for the same. Depression needs to be actively screened and managed appropriately in hypothyroid patients so as to avoid the devastating consequences of untreated depression. Some clinical indicators like obesity, cold intolerance and memory loss may signal the presence of depression in hypothyroid patients.
Keyword: Hypothyroidism, Thyroiditis, Depression, TPO, BMI.
Dr Abilash Nair, DM (Endocrinology)
Department of Endocrinology and Metabolism
Government Medical College, Thiruvananthapuram 695011
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