A STUDY OF THYROID HORMONES (T3, T4 & TSH) IN PATIENTS OF DEPRESSION

In this study, 32 unmedicated patients of unipolar depression were included and blood samples were analysed for T3, T4 and TSH. These were compared with age and sex matched controls. Subnormal T3 and T4 levels in 90.6% and 9.3% respectively and an increase of TSH levels in 18.7% of the total patients was observed in this study. The patients were classified into mild, moderate and severe grade of depression as per DSM-IV criteria. Of the mild 66.6%, 93.3% of moderate and all of the severe grade depression patients had low T3 levels. Of the moderately depressed patients 13.3% and 9.0% of severe depression patients had low T4 levels. TSH was increased than normal in 54.5% of the patients and all these patients were of severe grade. ANOVA with multiple comparison testing shows significant decrease in levels of T3 (F2.29 >3.33) and significant increase in TSH levels (F2.29 >3.33) at 5% level of significance amongst mild, moderate and severe grade of depression patients. This study suggests a subclinical hypothyroidism in most of the patients which could lead to nonresponsiveness to the conventional antidepressant therapy. Therefore, evaluation of thyroid status prior to antidepressant therapy and subsequent thyroid hormone substitution in subclinical hypothyroid patients is suggested.

[1]  M. Fava,et al.  Hypothyroidism and hyperthyroidism in major depression revisited. , 1995, The Journal of clinical psychiatry.

[2]  J. Macher,et al.  Influence of thyroid hormones on morning and evening TSH response to TRH in major depression , 1994, Biological Psychiatry.

[3]  M. Bauer,et al.  Psychological and endocrine abnormalities in refugees from East Germany: Part I. Prolonged stress, psychopathology, and hypothalamic-pituitary-thyroid axis activity , 1994, Psychiatry Research.

[4]  J. Nomura,et al.  Comparison of Thyroid Function between Responders and Nonresponders to Thyroid Hormone Supplementation in Depression , 1992, The Japanese journal of psychiatry and neurology.

[5]  R. Tissot,et al.  [Plasma MHPG, peripheral noradrenergic marker and hormonal plasma levels of cortisol-T3-T4-TSH in depressive syndromes]. , 1991, L'Encephale.

[6]  L. Tappy,et al.  Prevalence of Thyroid Disorders in Psychogeriatric Inpatients A Possible Relationship of Hypothyroidism with Neurotic Depression but not with Dementia , 1987, Journal of the American Geriatrics Society.

[7]  D. Drucker Hyperthyroxinemia in patients with acute psychiatric disorders. , 1983, The American journal of medicine.

[8]  M. Blackman,et al.  Thyroid hormone elevations during acute psychiatric illness: relationship to severity and distinction from hyperthyroidism. , 1990, Endocrine research.

[9]  T. Kosten,et al.  Serum concentrations of circulating thyroid hormones in a group of depressed men. , 1989, Neuropsychobiology.

[10]  S. Targum Persistent neuroendocrine dysregulation in major depressive disorder: a marker for early relapse. , 1984, Biological psychiatry.

[11]  J. Stewart Thyroid stimulating hormone and depression. , 1982, The American journal of psychiatry.