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 - 2014/5
Y1 - 2014/5
N2 - Background: Thyroid hormones are necessary for fetal brain development, and 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: This is an observational cohort study. On the basis of record linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 nonhypothyroid 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: Before 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 [CI 1.29-1.73]), antidepressants (OR 1.50 [CI 1.35-1.67]), and anxiolytics (OR 1.28 [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 [CI 1.81-3.18]), and an increased risk of being treated with antidepressants (HR 1.30 [CI 1.15-1.47]) and anxiolytics (HR 1.27 [CI 1.10-1.47]), but not antipsychotics (HR 1.13 [CI 0.91-1.41]). On the basis of 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, and 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: This is an observational cohort study. On the basis of record linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 nonhypothyroid 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: Before 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 [CI 1.29-1.73]), antidepressants (OR 1.50 [CI 1.35-1.67]), and anxiolytics (OR 1.28 [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 [CI 1.81-3.18]), and an increased risk of being treated with antidepressants (HR 1.30 [CI 1.15-1.47]) and anxiolytics (HR 1.27 [CI 1.10-1.47]), but not antipsychotics (HR 1.13 [CI 0.91-1.41]). On the basis of 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
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anti-Anxiety Agents/therapeutic use
KW - Antidepressive Agents/therapeutic use
KW - Antipsychotic Agents/therapeutic use
KW - Cohort Studies
KW - Comorbidity
KW - Denmark/epidemiology
KW - Drug Prescriptions
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Hypothyroidism/epidemiology
KW - International Classification of Diseases
KW - Male
KW - Medical Record Linkage
KW - Mental Disorders/drug therapy
KW - Middle Aged
KW - Prevalence
KW - Proportional Hazards Models
KW - Registries
KW - Risk
KW - Young Adult
U2 - 10.1089/thy.2013.0555
DO - 10.1089/thy.2013.0555
M3 - Journal article
C2 - 24383722
SN - 1050-7256
VL - 24
SP - 802
EP - 808
JO - Thyroid
JF - Thyroid
IS - 5
ER -