亚临床甲状腺功能减退与抑郁症之间的隐藏联系:文献综述

Sabitha Challa, Ahmed S Kabeil, Bithiah Inyang, Faisal J Gondal, G. Abah, Mahesh Minnal Dhandapani, M. Manne, M. Khanna, Lubna Mohammed
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引用次数: 0

摘要

亚临床甲状腺功能减退症和抑郁症之间的联系是公认的。发现甲状腺疾病患者更容易出现抑郁症状,抑郁可能伴有各种细微的甲状腺异常。最常见的异常是T4水平升高,T3水平低,rT3水平升高,TSH对TSH的反应减弱,抗甲状腺自身抗体阳性和脑脊液TRH浓度升高。研究还发现,甲状腺激素补充剂似乎可以加速和增强对抗抑郁药的临床反应。研究发现,由于甲状腺激素作用于中枢神经系统,抑郁症与下丘脑-垂体轴的变化有关。轻度甲状腺功能障碍在抑郁量表诊断的年轻患者(<60岁)中引起抑郁。研究发现,年龄的差异可能导致抑郁发作。抑郁发作,如焦虑和自杀的风险是相当大的因素,根据个人的年龄而不同。发现SCH与年轻成人(<60岁)的抑郁相关。SCH和正常甲状腺功能之间的唯一区别是TSH。在抑郁症和亚临床甲状腺功能减退症中,性别差异也已被认识到。采用贝克抑郁量表、汉密尔顿抑郁量表等抑郁评分方法评估亚临床甲状腺功能减退与抑郁症的关系。由于亚临床甲状腺功能减退与情绪低落、血清TSH、FT3、FT4水平及汉密尔顿抑郁相关,左旋甲状腺素治疗可显著降低TSH水平及汉密尔顿评分。由于甲状腺功能减退中抑郁症状的患病率较高,因此使用高TSH临界值,甲状腺功能减退的TSH临界值基于相关症状,最佳TSH临界值为2.5 MIU/L
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A Hidden Link between Subclinical Hypothyroidism and Depression: A literature Review
The association between Subclinical hypothyroidism and Depression is recognised. It is found that patients with Thyroid disorders are more prone to develop depressive symptoms and depression may be accompanied by various subtle thyroid abnormalities. The most commonly documented abnormalities are elevated T4 levels, Low T3, elevated rT3, a blunted TSH response to TSH, Positive anti thyroid autoantibodies and elevated CSF TRH concentrations. It is also found that thyroid hormone supplements appear to accelerate and enhance the clinical response to antidepressants. It is found out that Depression is associated with changes in Hypothalamic-pituitary axis as thyroid hormones act on the central nervous system. Mild thyroid dysfunction causes depression in younger patients (<60 years old) diagnosed by depressive scale. It was found that differences in age group may cause depressive episodes. Depressive episodes such as anxiety and the risk of committing suicide are considerable factors that differ according to the age of the individuals.SCH was found to be associated with depression in the younger adults (<60 years old). The only difference between SCH and normal thyroid function is TSH.In depressive disorder and subclinical hypothyroidism sex differences have also been recognised. Association between subclinical hypothyroidism and Depression is assessed by various depressive scores such as Beck Depression Inventory and Hamilton depression rating scale. As Subclinical hypothyroidism is associated with low mood, Serum levels of TSH, FT3, FT4 and Hamilton depression, treatment with Levothyroxine showed significant decrease is TSH levels and Hamilton scores were decreased. Since the prevalence of depressive symptoms in hypothyroidism is high TSH cut-off levels is used,TSH cut off value for hypothyroidism is based on associated symptoms,TSH cut-off value is 2.5 MIU/L is optimal
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