The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria

Kathol, Roger G.; DeLaHunt, John

doi:10.1016/0163-8343(86)90060-5

Cited by 83 publications

(43 citation statements)

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“…In elderly patients, 149 depressive symptoms such as apathy, lethargy, pseudodementia and depressed mood can also occur (41). Approximately 60% of thyrotoxic patients have an anxiety disorder and between 31% and 69% have a depressive disorder (42,43).…”

Section: Neuropsychiatric Changes In Thyroid and Mood Disordersmentioning

confidence: 99%

Association of Thyroid Dysfunction and Mood Disorders and Role of Imaging: a Review

Biswas

Dey

2016

Bangladesh J. Nuclear Med.

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Thyroid hormones play a critical role in the adult brain impacting mood and cognition. Some psychiatric symptoms are produced by thyroid illnesses and there is a frequent association of thyroid dysfunction with mood disorders. It is now clear that without optimal thyroid function, mood disturbance, cognitive impairment and other phychiatric symptoms can emerge. The usefulness of adding thyroid hormones to antidepressive treatment in euthyroid patients to obtain a potentiation effect has been proved repeatedly. The most common strategy is potentiation with T 3 , but high doses of T 4 have been also used in patients with resistant depression. Brain imaging techniques evaluating cerebral metabolism, perfusion, and anatomy enabled encouraging insights into the thyroid-brain relationship. The most consistent finding in patients with hypothyroidism is global diffuse hypoperfusion more pronounced in posterior brain region or in parietal lobe. Functional MRI in patients with thyroid diseases of different length and severity could help to identify functional aberrations such as memory impairments or altered emotional processing, which has long been suggested from animal studies. Structural changes related to myelin, which have been observed in various animal models, can now be studied with quantitative T2 or quantitative magnetization transfer (MT) imaging. Diffusion tensor imaging (DTI) can reveal information on white matter integrity.

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Section: Neuropsychiatric Changes In Thyroid and Mood Disordersmentioning

confidence: 99%

Association of Thyroid Dysfunction and Mood Disorders and Role of Imaging: a Review

Biswas

Dey

2016

Bangladesh J. Nuclear Med.

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“…Notably, research suggests that mood disorders, cognitive impairment, and other psychiatric symptoms may arise even in subjects with subclinically disturbed thyroid function (Zhu et al 2006). Patients with manifest thyroid disorders have been shown to have a higher disposition to the development of depressive symptoms (Hendrick et al 1998), including anxiety induced by hyperthyroidism (Kathol and Delahunt 1986). Conversely, depression may be accompanied by various subtle thyroid abnormalities.…”

Section: Introductionmentioning

confidence: 99%

“…Most consistently, higher mean FT4 levels have been reported in patients with MDD than in subjects with RMDD and healthy controls (Joffe 2006); moreover, these levels subsided with effective treatment . These increased FT4 levels might contribute to depressive symptoms by inducing higher levels of anxiety, as in hyperthyroidism (Kathol and Delahunt 1986). Thus, it has been hypothesized that the thyroid axis is overactive in MDD (Joffe and Sokolov 1994).…”

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confidence: 99%

Neural correlates of free T3 alteration after catecholamine depletion in subjects with remitted major depressive disorder and in controls

2013

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RationaleThyroid hormones and their interactions with catecholamines play a potentially important role in alterations of mood and cognition. ObjectivesThis study aimed to examine the neurobiological effects of catecholamine depletion on thyroid hormones by measuring endocrine and cerebral metabolic function in unmedicated subjects with remitted MDD (RMDD) and in healthy controls. MethodsThis was a randomized, placebo-controlled, and double-blind crossover trial that included 15 unmedicated RMDD subjects and 13 healthy control subjects. The participants underwent two 3-day-long sessions at 1-week intervals; each participant was randomly administered oral α-methyl-para-tyrosine (AMPT) in one session (catecholamine depletion) and an identical capsule containing hydrous lactose (sham depletion) in the other session prior to a [18 F]-fluorodeoxyglucose positron emission tomography scan ( 18 FDG-PET). ResultsSerum concentrations of free T3 (FT3), free T4 (FT4), and TSH were obtained and assessed with respect to their relationship to regional cerebral glucose metabolism. Both serum FT3 (P = 0.002) and FT4 (P = 0.0009) levels were less suppressed after catecholamine depletion compared with placebo treatment in the entire study sample. There was a positive association between both FT3 (P = 0.0005) and FT4 (P = 0.002) and depressive symptoms measured using the MADRS. The relative elevation in FT3 level was correlated with a decrease in regional glucose metabolism in the right dorsolateral prefrontal cortex (rDLPFC; P < 0.05, corrected).Homan et al.2 ConclusionsThis study provided evidence of an association between a thyroid-catecholamine interaction and mood regulation in the rDLPFC.

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“…Furthermore, several other studies have found these symptoms as well as other psychiatric symptoms associated with Grave's disease which include hypomania, mania, depression, psychosis, insomnia, attention and over activity problems, restlessness, fatigue, and delirium [26,[49][50][51][52][53][54][55][56][57][58]. As far as treatment, there are discrepancies with some studies that have found that psychiatric symptoms like anxiety generally improve with the treatment of hyperthyroidism [26,48,59]. However, other studies have reported that psychiatric symptoms persisted despite appropriate anti-thyroid treatment [47,[60][61][62][63].…”

mentioning

confidence: 99%

“…Stern et al, [47] found in their study of 137 patients with Grave's disease that the psychiatric symptoms of anxiety and irritability were strongly correlated with the disease. Kathol and Delahunt [48] reported that 60% of their hyperthyroid patients were found to have an anxiety disorder. Furthermore, several other studies have found these symptoms as well as other psychiatric symptoms associated with Grave's disease which include hypomania, mania, depression, psychosis, insomnia, attention and over activity problems, restlessness, fatigue, and delirium [26,[49][50][51][52][53][54][55][56][57][58].…”

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confidence: 99%

Psychiatric Manifestations of Endocrine Disorders

Solomon¹

2017

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The endocrine system has been studied extensively from physiological, biochemical, and molecular approaches. However, much less attention has concentrated on the psychological aspects associated with these different endocrine diseases, and the necessity of addressing these psychological issues in order to effectively treat endocrine patients. Often, there is a significant impairment in the quality of life when it comes to these different endocrine diseases, and an interdisciplinary approach is needed in order to achieve the best possible outcome for the patient. It is our goal through this review to provide a comprehensive assessment of the psychological implications associated with different endocrine disorders. Specifically, we will address the psychological aspects associated with diabetes, Cushing's syndrome, Addison's disease, hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoparathyroidism, pheochromocytoma, and androgen and estrogen disorders, as well as a brief correlation of transgender adults. Adrenal: Cushing's Syndrome and Addison's DiseaseOver the past few decades, a number of authors have found a significant amount of psychological disorders associated with Cushing's syndrome. Sonino and Fava [1] found that major depression is a life-threatening complication, which may affect 50-60% of patients with Cushing's syndrome. They found that it occurs in both the pituitary dependent and independent forms of the disease. Kelly et al., [2] found a similar association with 57% of 209 Cushing's syndrome patients having a significant psychiatric illness, usually depression. A follow-up study by Sonino et al.,[3] found that 54% of patients with pituitary-dependent Cushing disease had major depression according to DSM-IV criteria. They observed that the depression in Cushing's syndrome was significantly associated with female gender, older age, higher urinary cortisol levels, a relatively more severe clinical condition, and an absence of a pituitary adenoma. Other authors have also found the same correlation between depression and Cushing's syndrome [1,[4][5][6][7]. While depression is one of the most important psychological symptoms associated with Cushing's syndrome, other symptoms have been noticed. Starkman et al., [8] and Starkman [9] reported that around 66% of their Cushing's syndrome patients experienced generalized anxiety or panic disorders. Sonino et al., [10] also found a significant association between anxiety and Cushing's syndrome. In this same particular study, the authors also saw there was a significant association in their Cushing's syndrome patients with increased irritable mood, higher levels of stress, and lower physical well-being. Mania and hypomania are other psychological symptoms that have been associated with Cushing's syndrome by a number of authors [11,12].There has been a significant debate in the literature whether the psychological symptoms of Cushing's syndrome completely resolve after the remission of the disease. Several studies have found significant improvements or e...

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The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria

Cited by 83 publications

References 14 publications

Association of Thyroid Dysfunction and Mood Disorders and Role of Imaging: a Review

Association of Thyroid Dysfunction and Mood Disorders and Role of Imaging: a Review

Neural correlates of free T3 alteration after catecholamine depletion in subjects with remitted major depressive disorder and in controls

Psychiatric Manifestations of Endocrine Disorders

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