Evaluation of clinical and psychiatric symptoms in sub clinical hypothyroidism

• Published in: Revista da Associação Médica Brasileira (1992) Vol. 52; no. 4; pp. 222 - 228
• Main Authors: Teixeira, Patrícia de Fátima Dos Santos, Reuters, Vaneska Spinelli, Almeida, Cloyra Paiva, Ferreira, Márcia Martins, Wagman, Márcia Branco, Reis, Fabíola Alves Aarão, Costa, Antonio José Leal, Vaisman, Mário
• Format: Magazine Article
• Language: Portuguese
• Published: Brazil 01.07.2006
• Subjects: Adolescent; Adult; Age Factors; Aged; Antibodies - blood; Anxiety Disorders - etiology; Biomarkers - blood; Case-Control Studies; Cross-Sectional Studies; Depressive Disorder - etiology; Female; Humans; Hypothyroidism - drug therapy; Hypothyroidism - immunology; Hypothyroidism - psychology; Male; Mental Disorders - etiology; Middle Aged; Neuropsychological Tests; Peroxidases - blood; Statistics, Nonparametric; Thyrotropin - blood; Thyroxine - blood
• ISSN: 0104-4230

This investigation evaluated and correlated clinical, laboratorial aspects and psychiatric symptoms in sub clinical hypothyroidism (SH). Cross sectional study involving 103 patients with SH and 60 subjects without thyroid disease. Clinical and psychiatric evaluation was respectively based on the Zulewski score and Hamilton A, Hamilton D and Beck questionnaires. Serum thyreotropin (TSH), (thyroxine) FT4 and (antithyroperoxidase) ATPO were measured in all participants. Analysis of continuums data was assessed by the Student t- test, for normally distributed data, and by the Mann- Whitney and Kruskal Wallis tests for non-parametric data. The chi2, Fisher's and Kruskal Wallis tests were used to study qualitative variables. Multivariate analyses were used to study confounding variables. Mean serum TSH level was 7.76 +/- 2.9 micro UI/mL in SH and 1.66 +/- 0.6 micro UI/mL in the group without thyroid disease (p=0.001). Mean serum T4L was slightly lower among patients with HS, and showed a negative linear correlation with TSH. Higher frequencies of abnormal clinical score (48.3 vs. 67.0%; p=0.02), depression self reported symptoms (20.5 vs. 44.2%; p=0.011) and anxiety symptoms (86.0 vs. 63.4%; p=0.004) occurred more frequently in SH. Frequency of psychiatric symptoms had a positive correlation with the clinical score and serum TSH. There was no association between the clinical and psychiatric findings and the etiology of SH, presence of ATPO, age or menopause. The study showed that SH was associated with clinical findings and with psychiatric symptoms. Clinical trials are required to evaluate possible improvement with levotiroxine.