Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B

Abstract

Background Depression and insomnia in chronic hepatitis B (CHB) patients affect the quality of life, disease diagnosis, and mortality. CHB patients are more likely to have psychological disorders, but the underlying mechanisms have not been elucidated. This study investigated the incidence of depression in patients with CHB and sought to identify risk factors for depression and insomnia in these patients, focusing on changes in liver function and thyroid hormone levels. Material/Methods This cross-sectional cohort study used the Hamilton Depression Scale and Athens Insomnia Scale to assess the depressive and insomnia states, respectively, of 209 CHB patients. Liver function, thyroid hormone levels, hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B virus-deoxyribonucleic acid load were evaluated. Liver cirrhosis was assessed by imaging (color Doppler ultrasound and computed tomography). A multivariate logistic regression model was used to analyze the correlation among various factors and depression and insomnia. Results Subclinical and clinical depressive states were found in 23.9% and 5.3% and subclinical and clinical insomnia in 11% and 35.4% of patients, respectively. Depression and insomnia severity were significantly correlated with low FT3 (<3.5 mol/L). The odds ratios of low FT3 for subclinical and clinical depression and clinical insomnia were 3.07 (95% confidence interval (CI), 1.248–7.568), 7.85 (95% CI, 1.839–33.547), and 3.91 (95% CI, 1.417–10.789), respectively. Conclusions CHB patients are prone to depression and insomnia. FT3 reduction may be a risk factor for depression and insomnia. In clinical settings, more attention needs to be paid to the mental state of patients with FT3 reduction.

Dysregulated thyroid hormones correlate with anxiety and depression risk in patients with autoimmune disease

“…Besides, another study elucidates that untreated hypothyroidism is correlated with an increased score of Beck depression inventory (BDI‐II), and untreated hyperthyroidism is associated with diagnosis of major depression disorder (MDD) in 2142 individuals 12 . Additionally, a study reveals that in Chronic Hepatitis B (CHB) patients, the mean level of FT3 and percentage of patients with decreased FT3 level (less than < 3.5 mol/L) are markedly increased in CHB patients with clinical and subclinical depression compared to CHB patients without depression 29 . These data unveil that thyroid dysfunction is correlated with higher risk of developing anxiety and depression.…”

“…17,18 AID is often accompanied by dysregulation in thyroid function, which is common in several AIDs; for instance, SLE and RA patients are more likely to obtain thyroid dysfunction. 29 These data unveil that thyroid dysfunction is correlated with higher risk of developing anxiety and depression. However, the associations between these indexes related to thyroid function and anxiety or depression in AID patients are seldom investigated.…”

Sleep disorders related to nutrition and digestive diseases: a neglected clinical condition

“…3) [141,142]. An association with sleep disorders has been reported in chronic hepatitis B, but evidence is weak [143].…”

<p>Dual Metabolomic Platforms Identified a Novel Urinary Metabolite Signature for Hepatitis B Virus-Infected Patients with Depression</p>

“…4 Previous studies reported that HBVinfected patients had significantly higher levels of depression compared to healthy controls. 5,6 Depression could decrease the quality of life of HBV-infected patients. But one of the most serious consequences caused by depression is reducing patients' compliance with prolonged therapeutic regimens.…”