Increased psychiatric morbidity before and after the diagnosis of hypothyroidism: A nationwide register study

Marianne Thvilum, Frans Brandt, Dorthe Almind Pedersen, Kaare Christensen, Thomas Heiberg Brix, Laszlo Hegedus

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively. Results: Prior to the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (Odds ratio, OR, 1.51; 95% confidence interval (CI): 1.12-2.04) and increased prevalence of treatment with antipsychotics (OR 1.49; 95% CI: 1.29-1.73), antidepressants (OR 1.50; 95% CI: 1.35-1.67), and anxiolytics (OR 1.28; 95% CI: 1.16-1.41). After the diagnosis of hypothyroidism, patients had a higher risk of being diagnosed with a psychiatric disorder (Hazard ratio, HR, 2.40; 95% CI: 1.81-3.18), and an increased risk of being treated with antidepressants (HR 1.30; 95% CI: 1.15-1.47) and anxiolytics (HR 1.27; 95% CI: 1.10-1.47), but not antipsychotics (HR 1.13; 95% CI: 0.91-1.41). Based on the twin data, we could not demonstrate genetic confounding. Conclusions: Subjects with hypothyroidism have an increased risk of being diagnosed with a psychiatric disorder as well as being treated with antidepressants, antipsychotics and anxiolytics both before and after the diagnosis of hypothyroidism.
OriginalsprogEngelsk
TidsskriftThyroid
Vol/bind24
Udgave nummer5
Sider (fra-til)802-8
ISSN1050-7256
DOI
StatusUdgivet - 2014

Fingeraftryk

Confidence Intervals
Proportional Hazards Models
Cohort Studies
Logistic Models
Odds Ratio
Quality of Life
Health

Emneord

  • Hypothyroidism
  • Register study
  • Twins
  • Depression
  • Psychoses
  • Anxiety
  • Psychiatric morbidity
  • Myxedema

Citer dette

Thvilum, Marianne ; Brandt, Frans ; Pedersen, Dorthe Almind ; Christensen, Kaare ; Brix, Thomas Heiberg ; Hegedus, Laszlo. / Increased psychiatric morbidity before and after the diagnosis of hypothyroidism : A nationwide register study. I: Thyroid. 2014 ; Bind 24, Nr. 5. s. 802-8.
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title = "Increased psychiatric morbidity before and after the diagnosis of hypothyroidism: A nationwide register study",
abstract = "Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively. Results: Prior to the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (Odds ratio, OR, 1.51; 95{\%} confidence interval (CI): 1.12-2.04) and increased prevalence of treatment with antipsychotics (OR 1.49; 95{\%} CI: 1.29-1.73), antidepressants (OR 1.50; 95{\%} CI: 1.35-1.67), and anxiolytics (OR 1.28; 95{\%} CI: 1.16-1.41). After the diagnosis of hypothyroidism, patients had a higher risk of being diagnosed with a psychiatric disorder (Hazard ratio, HR, 2.40; 95{\%} CI: 1.81-3.18), and an increased risk of being treated with antidepressants (HR 1.30; 95{\%} CI: 1.15-1.47) and anxiolytics (HR 1.27; 95{\%} CI: 1.10-1.47), but not antipsychotics (HR 1.13; 95{\%} CI: 0.91-1.41). Based on the twin data, we could not demonstrate genetic confounding. Conclusions: Subjects with hypothyroidism have an increased risk of being diagnosed with a psychiatric disorder as well as being treated with antidepressants, antipsychotics and anxiolytics both before and after the diagnosis of hypothyroidism.",
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Increased psychiatric morbidity before and after the diagnosis of hypothyroidism : A nationwide register study. / Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind; Christensen, Kaare; Brix, Thomas Heiberg; Hegedus, Laszlo.

I: Thyroid, Bind 24, Nr. 5, 2014, s. 802-8.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

T2 - A nationwide register study

AU - Thvilum, Marianne

AU - Brandt, Frans

AU - Pedersen, Dorthe Almind

AU - Christensen, Kaare

AU - Brix, Thomas Heiberg

AU - Hegedus, Laszlo

PY - 2014

Y1 - 2014

N2 - Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively. Results: Prior to the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (Odds ratio, OR, 1.51; 95% confidence interval (CI): 1.12-2.04) and increased prevalence of treatment with antipsychotics (OR 1.49; 95% CI: 1.29-1.73), antidepressants (OR 1.50; 95% CI: 1.35-1.67), and anxiolytics (OR 1.28; 95% CI: 1.16-1.41). After the diagnosis of hypothyroidism, patients had a higher risk of being diagnosed with a psychiatric disorder (Hazard ratio, HR, 2.40; 95% CI: 1.81-3.18), and an increased risk of being treated with antidepressants (HR 1.30; 95% CI: 1.15-1.47) and anxiolytics (HR 1.27; 95% CI: 1.10-1.47), but not antipsychotics (HR 1.13; 95% CI: 0.91-1.41). Based on the twin data, we could not demonstrate genetic confounding. Conclusions: Subjects with hypothyroidism have an increased risk of being diagnosed with a psychiatric disorder as well as being treated with antidepressants, antipsychotics and anxiolytics both before and after the diagnosis of hypothyroidism.

AB - Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively. Results: Prior to the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (Odds ratio, OR, 1.51; 95% confidence interval (CI): 1.12-2.04) and increased prevalence of treatment with antipsychotics (OR 1.49; 95% CI: 1.29-1.73), antidepressants (OR 1.50; 95% CI: 1.35-1.67), and anxiolytics (OR 1.28; 95% CI: 1.16-1.41). After the diagnosis of hypothyroidism, patients had a higher risk of being diagnosed with a psychiatric disorder (Hazard ratio, HR, 2.40; 95% CI: 1.81-3.18), and an increased risk of being treated with antidepressants (HR 1.30; 95% CI: 1.15-1.47) and anxiolytics (HR 1.27; 95% CI: 1.10-1.47), but not antipsychotics (HR 1.13; 95% CI: 0.91-1.41). Based on the twin data, we could not demonstrate genetic confounding. Conclusions: Subjects with hypothyroidism have an increased risk of being diagnosed with a psychiatric disorder as well as being treated with antidepressants, antipsychotics and anxiolytics both before and after the diagnosis of hypothyroidism.

KW - Hypothyroidism

KW - Register study

KW - Twins

KW - Depression

KW - Psychoses

KW - Anxiety

KW - Psychiatric morbidity

KW - Myxedema

U2 - 10.1089/thy.2013.0555

DO - 10.1089/thy.2013.0555

M3 - Journal article

C2 - 24383722

VL - 24

SP - 802

EP - 808

JO - Thyroid

JF - Thyroid

SN - 1050-7256

IS - 5

ER -