Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis
Thyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still con...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-07-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/57/7/714 |
| _version_ | 1797526659886219264 |
|---|---|
| author | Freddy J. K. Toloza Yuanjie Mao Lakshmi Menon Gemy George Madhura Borikar Soumya Thumma Hooman Motahari Patricia Erwin Richard Owen Spyridoula Maraka |
| author_facet | Freddy J. K. Toloza Yuanjie Mao Lakshmi Menon Gemy George Madhura Borikar Soumya Thumma Hooman Motahari Patricia Erwin Richard Owen Spyridoula Maraka |
| author_sort | Freddy J. K. Toloza |
| collection | DOAJ |
| description | Thyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still controversial. We conducted a systematic review and meta-analysis to describe the association of thyroid function with suicidal behavior in adults. We searched four data bases (MEDLINE, EMBASE, PsycINFO, and Scopus) from their inception to 20 July 2018. Studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3)] in patients with suicidal behavior compared with controls were included in this meta-analysis. The abstracts and papers retrieved with our search strategies were reviewed independently and in duplicate by four reviewers for assessment of inclusion criteria and data extraction, as well as for evaluation of risk of bias. Random-effects models were used in this meta-analysis to establish the mean difference on thyroid function tests between groups. Overall, 2278 articles were identified, and 13 studies met the inclusion criteria. These studies involved 2807 participants, including 826 participants identified with suicidal behavior. We found that patients with suicide behavior had lower levels of FT3 (−0.20 pg/mL; <i>p</i> = 0.02) and TT4 (−0.23 µg/dL; <i>p</i> = 0.045) compared to controls. We found no differences in either TSH, FT4, or TT3 levels among groups. With our search strategy, we did not identify studies with a comparison of overt/subclinical thyroid disease prevalence between patients with and without suicide behavior. The studies included in this meta-analysis had a low-to-moderate risk of bias. In the available literature, the evidence regarding the association of thyroid disorders and suicidal behavior is limited. We found that patients with suicidal behavior have significantly lower mean FT3 and TT4 levels when compared to patients without suicidal behavior. The clinical implications and pathophysiologic mechanisms of these differences remain unknown and further research is needed. |
| first_indexed | 2024-03-10T09:32:27Z |
| format | Article |
| id | doaj.art-76f3f7f9204d46c7a2c466b13332f30f |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T09:32:27Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-76f3f7f9204d46c7a2c466b13332f30f2023-11-22T04:21:35ZengMDPI AGMedicina1010-660X1648-91442021-07-0157771410.3390/medicina57070714Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-AnalysisFreddy J. K. Toloza0Yuanjie Mao1Lakshmi Menon2Gemy George3Madhura Borikar4Soumya Thumma5Hooman Motahari6Patricia Erwin7Richard Owen8Spyridoula Maraka9Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USAMayo Clinic Libraries, Mayo Clinic, Rochester, MN 55902, USADepartment of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USADivision of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USAThyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still controversial. We conducted a systematic review and meta-analysis to describe the association of thyroid function with suicidal behavior in adults. We searched four data bases (MEDLINE, EMBASE, PsycINFO, and Scopus) from their inception to 20 July 2018. Studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3)] in patients with suicidal behavior compared with controls were included in this meta-analysis. The abstracts and papers retrieved with our search strategies were reviewed independently and in duplicate by four reviewers for assessment of inclusion criteria and data extraction, as well as for evaluation of risk of bias. Random-effects models were used in this meta-analysis to establish the mean difference on thyroid function tests between groups. Overall, 2278 articles were identified, and 13 studies met the inclusion criteria. These studies involved 2807 participants, including 826 participants identified with suicidal behavior. We found that patients with suicide behavior had lower levels of FT3 (−0.20 pg/mL; <i>p</i> = 0.02) and TT4 (−0.23 µg/dL; <i>p</i> = 0.045) compared to controls. We found no differences in either TSH, FT4, or TT3 levels among groups. With our search strategy, we did not identify studies with a comparison of overt/subclinical thyroid disease prevalence between patients with and without suicide behavior. The studies included in this meta-analysis had a low-to-moderate risk of bias. In the available literature, the evidence regarding the association of thyroid disorders and suicidal behavior is limited. We found that patients with suicidal behavior have significantly lower mean FT3 and TT4 levels when compared to patients without suicidal behavior. The clinical implications and pathophysiologic mechanisms of these differences remain unknown and further research is needed.https://www.mdpi.com/1648-9144/57/7/714suicidethyroid functionhypothyroidismhyperthyroidism |
| spellingShingle | Freddy J. K. Toloza Yuanjie Mao Lakshmi Menon Gemy George Madhura Borikar Soumya Thumma Hooman Motahari Patricia Erwin Richard Owen Spyridoula Maraka Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis Medicina suicide thyroid function hypothyroidism hyperthyroidism |
| title | Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis |
| title_full | Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis |
| title_fullStr | Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis |
| title_short | Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis |
| title_sort | association of thyroid function with suicidal behavior a systematic review and meta analysis |
| topic | suicide thyroid function hypothyroidism hyperthyroidism |
| url | https://www.mdpi.com/1648-9144/57/7/714 |
| work_keys_str_mv | AT freddyjktoloza associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT yuanjiemao associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT lakshmimenon associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT gemygeorge associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT madhuraborikar associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT soumyathumma associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT hoomanmotahari associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT patriciaerwin associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT richardowen associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis AT spyridoulamaraka associationofthyroidfunctionwithsuicidalbehaviorasystematicreviewandmetaanalysis |