AccScience Publishing / JCBP / Volume 1 / Issue 2 / DOI: 10.36922/jcbp.1130
Cite this article
55
Download
1117
Views
Journal Browser
Volume | Year
Issue
Search
News and Announcements
View All
ORIGINAL RESEARCH ARTICLE

Mutuality of thyroid hormones and psychiatric disorders

Sandra Vuk Pisk1,2* Natko Gereš1,2 Karla Laškarin1 Katarina Matić1 Nedjeljka Ruljančić1 Ena Ivezić1,2 Igor Filipčić1,2,3
Show Less
1 Department of Integrative Psychiatry, University Psychiatric Hospital Sveti Ivan, Zagreb, Croatia
2 Department of Psychiatry and Neurology, Faculty of Dental Medicine and Health, “Josip Juraj Strossmayer” University of Osijek, Osijek, Croatia
3 Department of Psychiatry and Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia
Submitted: 25 June 2023 | Accepted: 23 August 2023 | Published: 20 September 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Abnormalities in thyroid function may induce affective, anxious, psychotic, and cognitive disorders and are a potential marker for assessing suicidal risk in patients suffering from psychiatric disorders. This retrospective, cross-sectional, electronic, and data-based study, comprising 118 adult psychiatric patients, aimed to establish differences in the concentrations of total T3, T4, and thyroid-stimulating hormone among patients diagnosed with common psychiatric disorders. The analysis encompassed the levels of these hormones in patients who had attempted suicide and those who had not. Lower values of total T3 were observed in patients with depressive disorder compared to patients with psychotic and bipolar disorder, as well as the control group. Furthermore, lower total T3 values were observed in patients who had reported a suicide attempt in their lives compared to participants who had not attempted suicide. These findings suggest a potential link between thyroid hormones and the regulation of central serotonin activity. The study underscores the importance of routinely assessing thyroid function in clinical practice to facilitate early detection of suicidality and the prevention of suicide.

Keywords
Thyroid hormones
Hypothalamic-pituitary-adrenal axis
Suicide prevention
Psychiatric disorders
Suicidality
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Mann JJ, Currier D, 2007, A review of prospective studies of biologic predictors of suicidal behavior in mood disorders. Arch Suicide Res, 11: 3–16. https://doi.org/10.1080/13811110600993124

 

  1. Delshad H, Mehran L, Tohidi M, et al., 2012, The incidence of thyroid function abnormalities and natural course of subclinical thyroid disorders, Tehran, I.R. Iran. J Endocrinol Invest, 35: 516–521. https://doi.org/10.3275/7968

 

  1. Soheili-Nezhad S, Sprooten E, Tendolkar I, et al., 2023, Exploring the genetic link between thyroid dysfunction and common psychiatric disorders: A specific hormonal or a general autoimmune comorbidity. Thyroid, 33: 159–168. https://doi.org/10.1089/thy.2022.0304

 

  1. Dickerman AL, Barnhill JW, 2012, Abnormal thyroid function tests in psychiatric patients: A red herring? Am J Psychiatry, 169: 127–133. https://doi.org/10.1176/appi.ajp.2011.11040631

 

  1. Vogel A, Elberling TV, Hørding M, et al., 2007, Affective symptoms and cognitive functions in the acute phase of Graves’ thyrotoxicosis. Psychoneuroendocrinology, 32: 36–43. https://doi.org/10.1016/j.psyneuen.2006.09.012

 

  1. Feldman AZ, Shrestha RT, Hennessey JV, 2013, Neuropsychiatric manifestations of thyroid disease. Endocrinol Metab Clin North Am, 42: 453–476. https://doi.org/10.1016/j.ecl.2013.05.005

 

  1. Ittermann T, Völzke H, Baumeister SE, et al., 2015, Diagnosed thyroid disorders are associated with depression and anxiety. Soc Psychiatry Psychiatr Epidemiol, 50: 1417–1425. https://doi.org/10.1007/s00127-015-1043-0

 

  1. Bauer M, London ED, Silverman DHS, et al., 2003, Thyroid, brain and mood modulation in affective disorder: Insights from molecular research and functional brain imaging. Pharmacopsychiatry, 36: 215–221. https://doi.org/10.1055/s-2003-45133

 

  1. Samuels MH, 2014, Psychiatric and cognitive manifestations of hypothyroidism. Curr Opin Endocrinol Diabetes Obes, 21: 377–383. https://doi.org/10.1097/MED.0000000000000089

 

  1. Trifu S, Popescu A, Dragoi AM, et al., 2020, Thyroid hormones as a third line of augmentation medication in treatment-resistant depression. Acta Endocrinol (Buchar), 16: 256–261. https://doi.org/10.4183/aeb.2020.256

 

  1. Carvalho AF, Cavalcante JL, Castelo MS, et al., 2007, Augmentation strategies for treatment‐resistant depression: A literature review. J Clin Pharm Ther, 32: 415–428. https://doi.org/10.1111/j.1365-2710.2007.00846.x

 

  1. Qiao D, Liu H, Zhang X, et al., 2022, Exploring the potential of thyroid hormones to predict clinical improvements in depressive patients: A machine learning analysis of the real-world based study. J Affect Disord, 299: 159–165. https://doi.org/10.1016/j.jad.2021.11.055

 

  1. Kessler L, Nedeltcheva A, Imperial J, et al., 2010, Changes in serum TSH and free T4 during human sleep restriction. Sleep, 33: 1115–1118. https://doi.org/10.1093/sleep/33.8.1115

 

  1. Koulouri O, Moran C, Halsall D, et al., 2013, Pitfalls in the measurement and interpretation of thyroid function tests. Best Pract Res Clin Endocrinol Metab, 27: 745–762. https://doi: 10.1016/j.beem.2013.10.003

 

  1. Fugger G, Dold M, Bartova L, et al., 2018, Comorbid thyroid disease in patients with major depressive disorder - results from the European Group for the Study of Resistant Depression (GSRD). Eur Neuropsychopharmacol, 28: 752–760. htttps://doi.org/10.1016/j.euroneuro.2018.03.011

 

  1. Chakrabarti S, 2011, Thyroid functions and bipolar affective disorder. J Thyroid Res, 2011: 306367. https://doi.org/10.4061/2011/306367

 

  1. Bauer M, Heinz A, Whybrow PC, 2002, Thyroid hormones, serotonin and mood: Of synergy and significance in the adult brain. Mol Psychiatry, 7: 140–156. https://doi.org/10.1038/sj.mp.4000963

 

  1. Krulich L, 1982, Neurotransmitter control of thyrotropin secretion. Neuroendocrinology, 35: 139–147. https://doi.org/10.1159/000123369

 

  1. Martinez S, Guttierez M, Delgado-Enciso I, et al., 2022, Economic and cardiometabolic risk factors are predictors of lower thyroid stimulating hormone (TSH) levels in hispanic/ latinx adults with euthyroidism-a community-based study. Int J Environ Res Public Health, 19: 8142. https://doi.org/10.3390/ijerph19138142

 

  1. Sharif K, Tiosano S, Watad A, et al., 2018, The link between schizophrenia and hypothyroidism: A population-based study. Immunol Res, 66: 663–667. https://doi.org/10.1007/s12026-018-9030-7

 

  1. Zhu Y, Ji H, Tao L, et al., 2020, Functional status of hypothalamic-pituitary-thyroid and hypothalamic-pituitary-adrenal axes in hospitalized schizophrenics in Shanghai. Front Psychiatry, 11: 65. https://doi.org/10.3389/fpsyt.2020.00065

 

  1. Kelly DL, Conley RR, 2005. Thyroid function in treatment-resistant schizophrenia patients treated with quetiapine, risperidone, or fluphenazine. J Clin Psychiatry, 66: 80–84. https://doi.org/10.4088/jcp.v66n0111

 

  1. Sim K, Chong SA, Chan YH, et al., 2002, Thyroid dysfunction in chronic schizophrenia within a state psychiatric hospital. Ann Acad Med Singapore, 31: 641–644.

 

  1. Santos NC, Costa P, Ruano D, et al., 2012, Revisiting thyroid hormones in schizophrenia. J Thyroid Res, 2012: 569147. https://doi.org/10.1155/2012/569147

 

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. United States: American Psychiatric Association. https://doi.org/10.1176/appi.books9780890425596

 

  1. Arsenault-Lapierre G, Kim C, Turecki G, 2004, Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry, 4: 37. https://doi.org/10.1186/1471-244X-4-37

 

  1. Bradvik L, 2018, Suicide risk and mental disorders. Int J Environ Res Public Health, 15: 2028. https://doi.org/10.3390/ijerph15092028

 

  1. Turecki G, Brent DA, 2016, Suicide and suicidal behaviour. Lancet, 387: 1227–1239. https://doi.org/10.1016/S0140-6736(15)00234-2

 

  1. Pompili M, Serafini G, Innamorati M, et al., 2010, The hypothalamic-pituitary-adrenal axis and serotonin abnormalities: A selective overview for the implications of suicide prevention. Eur Arch Psychiatry Clin Neurosci, 260: 583–600. https://doi.org/10.1007/s00406-010-0108-z

 

  1. Höfer P, Schosser A, Calati R, et al., 2016, The impact of serotonin receptor 1A and 2A gene polymorphisms and interactions on suicide attempt and suicide risk in depressed patients with insufficient response to treatment-a European multicentre study. Int Clin Psychopharmacol, 31: 1–7. https://doi.org/10.1097/YIC.0000000000000101

 

  1. Duval F, Mokrani MC, Lopera FG, et al., 2010. Thyroid axis activity and suicidal behavior in depressed patients. Psychoneuroendocrinol, 35: 1045–1054. https://doi.org/10.1016/j.psyneuen.2010.01.005

 

  1. Mann JJ, 2003, Neurobiology of suicidal behavior. Nat Rev Neurosci, 4: 819–828. https://doi.org/10.1038/nrn1220

 

  1. Duval F, Mokrani MC, Monreal J, et al., 2002, Interaction between the serotonergic system and HPA and HPT axes in patients with major depression: Implications for pathogenesis of suicidal behavior. Dialogues Clin Neurosci, 4: 417. https://doi.org/10.31887/DCNS.2002.4.4/fduval

 

  1. Gesing A, Lewiński A, Karbownik-Lewińska M, 2012, The thyroid gland and the process of aging; what is new? Thyroid Res, 5: 16. https://doi.org/10.1186/1756-6614-5-16

 

  1. Gitlin M, Altshuler LL, Frye MA, et al., 2004, Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors. J Psychiatry Neurosci, 29: 383–386.

 

  1. Duval F, Mokrani MC, Danila V, et al., 2022, Dopamine function and hypothalamic-pituitary-thyroid axis activity in major depressed patients with suicidal behavior. Brain Sci, 12: 621. https://doi.org/10.3390/brainsci12050621

 

  1. Jose J, Nandeesha H, Kattimani S, et al., 2015, Association between prolactin and thyroid hormones with severity of psychopathology and suicide risk in drug free male schizophrenia. Clin Chim Acta, 444: 78–80. https://doi.org/10.1016/j.cca.2015.02.003

 

  1. Praharaj SK, 2016, Thyroid abnormalities and suicidality in patients with first-episode schizophrenia. Thyroid Res Pract, 13: 147.

 

  1. Radhakrishnan R, Calvin S, Singh JK, et al., 2013, Thyroid dysfunction in major psychiatric disorders in a hospital based sample. Indian J Med Res, 138: 888–893.

 

  1. Shen Y, Wu F, Zhou Y, et al., 2019, Association of thyroid dysfunction with suicide attempts in first-episode and drug naive patients with major depressive disorder. J Affect Disord, 259: 180–185. https://doi.org/10.1016/j.jad.2019.08.067

 

  1. Shrivastava A, Jadhav V, Karia S, et al., 2016, Serum thyroid stimulating hormone levels and suicidal tendency in patients with first-episode schizophrenia: An exploratory study. Thyroid Res Pract, 13: 63–66.

 

  1. Corrigan MHN, Gillette GM, Quade D, et al., 1992, Panic, suicide, and agitation: Independent correlates of the TSH response to TRH in depression. Biol Psychiatry, 31: 984–992. https://doi.org/10.1016/0006-3223(92)90092-e

 

  1. Sinai C, Hirvikoski T, Vansvik ED, et al., 2009, Thyroid hormones and personality traits in attempted suicide. Psychoneuroendocrinol, 34: 1526–1532. https://doi.org/10.1016/j.psyneuen.2009.05.009

 

  1. Ozcan H, Yucel A, Atis O, et al., 2016, Thyroxin levels associated with current suicide attempts: A case control and follow-up study. Psychiatry Clin Psychopharmacol, 26: 278–286.

 

  1. Horowitz GL, Altaie S, Boyd JC, 2010, Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline. Wayne, PA: CLSI.

 

  1. Su M, Li E, Tang C, et al., 2019, Comparison of blood lipid profile/thyroid function markers between unipolar and bipolar depressed patients and in depressed patients with anhedonia or suicidal thoughts. Mol Med, 25: 51. https://doi.org/10.1186/s10020-019-0119-9

 

  1. Premachandra BN, Kabir MA, Williams IK, 2006, Low T 3 syndrome in psychiatric depression. J Endocrinol Invest, 29: 568–572. https://doi.org/10.1007/BF03344150

 

  1. Bartalena L, Pellegrini L, Meschi M, et al., 1990, Evaluation of thyroid function in patients with rapid-cycling and non-rapid-cycling bipolar disorder. Psychiatry Res, 34: 13–17. https://doi.org/10.1016/0165-1781(90)90054-9

 

  1. Kraszewska A, Ziemnicka K, Jończyk-Potoczna K, et al., 2019, Thyroid structure and function in long-term lithium-treated and lithium-naïve bipolar patients. Hum Psychopharmacol, 34: e2708. https://doi.org/10.1002/hup.2708

 

  1. Cassidy F, Ahearn EP, Carroll BJ, 2002, Thyroid function in mixed and pure manic episodes. Bipolar Disord, 4: 393–397. https://doi.org/10.1034/j.1399-5618.2002.01214.x

 

  1. Jokinen J, Samuelsson M, Nordström AL, et al., 2008, HPT axis, CSF monoamine metabolites, suicide intent and depression severity in male suicide attempters. J Affect Disord, 111: 119–124. https://doi.org/10.1016/j.jad.2008.02.001

 

  1. Pompili M, Gibiino S, Innamorati M, et al., 2012, Prolactin and thyroid hormone levels are associated with suicide attempts in psychiatric patients. Psychiatry Res, 200: 389–394. https://doi.org/10.1016/j.psychres.2012.05.010

 

  1. Rich CL, 1986, Endocrinology and suicide. Suicide Life Threat Behav, 16: 301–311. https://doi.org/10.1111/j.1943-278x.1986.tb00357.x

 

  1. Duval F, Mokran MC, Bailey P, et al., 1999, Thyroid axis activity and serotonin function in major depressive episode. Psychoneuroendocrinol, 24: 695–712. https://doi.org/10.1016/s0306-4530(99)00022-0
Share
Back to top
Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Published by AccScience Publishing