Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis
Background: Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism (SCH) is controversial. To date, there is a lack of data on the improvement of depressive symptoms with levothyroxine therapy among individuals with...
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BMC
2019
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| _version_ | 1796960795913879552 |
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| author | Loh, Huai Heng Lim, Lee Ling Yee, Anne Loh, Huai Seng |
| author_facet | Loh, Huai Heng Lim, Lee Ling Yee, Anne Loh, Huai Seng |
| author_sort | Loh, Huai Heng |
| collection | UM |
| description | Background: Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism (SCH) is controversial. To date, there is a lack of data on the improvement of depressive symptoms with levothyroxine therapy among individuals with coexistent SCH. Methods: We conducted a meta-analysis to evaluate the association between SCH and depression including 1) the prevalence of depression in SCH (with a sub-analysis of the geriatric cohort), 2) thyroid stimulating hormone (TSH) level among patients with depression and 3) the effect of levothyroxine therapy among patients with SCH and coexistent depression. Results: In a pooled analysis of 12,315 individuals, those with SCH had higher risk of depression than euthyroid controls (relative risk 2.35, 95% confidence intervals [CI], 1.84 to 3.02; p < 0.001). Geriatric cohort with SCH had a 1.7-fold higher risk of depression compared with healthy controls (odds ratio 1.72, CI, 1.10 to 2.70; p = 0.020). There was no difference in the mean TSH level between individuals with depression and healthy controls (2.30 ± 1.18 vs. 2.13 ± 0.72 mIU/L, p = 0.513). In individuals with SCH and coexistent depression, levothyroxine therapy was neither associated with improvement in the Beck Depression Inventory scoring (pooled d + = - 1.05, CI -2.72 to 0.61; p = 0.215) nor Hamilton Depression Rating Scale (pooled d + = - 2.38, CI -4.86 to 0.10; p = 0.060). Conclusion: SCH has a negative impact on depression. Early and routine screening of depression is essential to prevent morbidity and mortality. However, the use of levothyroxine among patients with SCH and coexistent depression needs to be individualized. |
| first_indexed | 2024-03-06T05:50:01Z |
| format | Article |
| id | um.eprints-20035 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:50:01Z |
| publishDate | 2019 |
| publisher | BMC |
| record_format | dspace |
| spelling | um.eprints-200352019-01-17T03:13:11Z http://eprints.um.edu.my/20035/ Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis Loh, Huai Heng Lim, Lee Ling Yee, Anne Loh, Huai Seng R Medicine Background: Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism (SCH) is controversial. To date, there is a lack of data on the improvement of depressive symptoms with levothyroxine therapy among individuals with coexistent SCH. Methods: We conducted a meta-analysis to evaluate the association between SCH and depression including 1) the prevalence of depression in SCH (with a sub-analysis of the geriatric cohort), 2) thyroid stimulating hormone (TSH) level among patients with depression and 3) the effect of levothyroxine therapy among patients with SCH and coexistent depression. Results: In a pooled analysis of 12,315 individuals, those with SCH had higher risk of depression than euthyroid controls (relative risk 2.35, 95% confidence intervals [CI], 1.84 to 3.02; p < 0.001). Geriatric cohort with SCH had a 1.7-fold higher risk of depression compared with healthy controls (odds ratio 1.72, CI, 1.10 to 2.70; p = 0.020). There was no difference in the mean TSH level between individuals with depression and healthy controls (2.30 ± 1.18 vs. 2.13 ± 0.72 mIU/L, p = 0.513). In individuals with SCH and coexistent depression, levothyroxine therapy was neither associated with improvement in the Beck Depression Inventory scoring (pooled d + = - 1.05, CI -2.72 to 0.61; p = 0.215) nor Hamilton Depression Rating Scale (pooled d + = - 2.38, CI -4.86 to 0.10; p = 0.060). Conclusion: SCH has a negative impact on depression. Early and routine screening of depression is essential to prevent morbidity and mortality. However, the use of levothyroxine among patients with SCH and coexistent depression needs to be individualized. BMC 2019 Article PeerReviewed Loh, Huai Heng and Lim, Lee Ling and Yee, Anne and Loh, Huai Seng (2019) Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. BMC Psychiatry, 19 (1). p. 12. ISSN 1471-244X, DOI https://doi.org/10.1186/s12888-018-2006-2 <https://doi.org/10.1186/s12888-018-2006-2>. https://doi.org/10.1186/s12888-018-2006-2 doi:10.1186/s12888-018-2006-2 |
| spellingShingle | R Medicine Loh, Huai Heng Lim, Lee Ling Yee, Anne Loh, Huai Seng Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis |
| title | Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis |
| title_full | Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis |
| title_fullStr | Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis |
| title_full_unstemmed | Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis |
| title_short | Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis |
| title_sort | association between subclinical hypothyroidism and depression an updated systematic review and meta analysis |
| topic | R Medicine |
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