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Autoimmune thyroiditis linked to depression, anxiety disorders

Patients with autoimmune thyroiditis had higher depression and anxiety disorder scores than healthy patients, according to findings published in JAMA Psychiatry.

“Despite growing interest in the psychiatric implications of [autoimmune thyroiditis], most published studies still focus on its somatic effects,” Eva-Maria Siegmann, BSc, department of psychiatry and psychotherapy, Friedrich-Alexander University, Germany, and colleagues wrote. “To our knowledge, there are only a few qualitative reviews describing an association between [autoimmune thyroiditis] and the development of depression and anxiety disorders, whereas no quantitative analysis concerning this topic exists.”

Researchers conducted a systematic search of clinical databases to examine meta-analytic data from case-control studies that reported the relationship between autoimmune thyroiditis and either depression or anxiety disorders, or both. Specifically, the investigators performed two univariate random-effects meta-analyses, tested moderators with Bonferroni-corrected meta-regression analysis and assessed heterogeneity with the I² statistic. They analyzed the OR of patients with autoimmune thyroiditis and depression compared with healthy controls, and the OR of patients with autoimmune thyroiditis and anxiety disorders compared with healthy controls.

Overall, 19 studies that comprised 21 independent samples and 36,174 patients (35,168 for depression and 34,094 for anxiety) were included in the meta-analysis. The results showed participants with autoimmune thyroiditis, Hashimoto’s thyroiditis or subclinical or overt hypothyroidism had significantly higher depression scores compared with controls (OR = 3.56; 95%CI, 2.14-5.94; I² = 92.1%). Participants with these same thyroid disorders also had higher anxiety scores than healthy controls (OR = 2.32; 95%CI, 1.4-3.85; I² = 89.8%).

Results from the sensitivity analysis showed significant amounts of heterogeneity for the depression model (Q = 205.8; P < .001; I² = 92.1%) and the anxiety model (Q = 104.4; P < .001; I² = 89.8%). The authors identified funnel plot asymmetry for studies of depression.

“In patients with depression and anxiety disorders, a test for [autoimmune thyroiditis] should be performed and in patients with [autoimmune thyroiditis], a screening for psychiatric symptoms is necessary,” Siegmann and colleagues wrote. “Advantages for patients are appropriate treatment taking into consideration early administration of antidepressants and facilitated coping owing to a better (biopsychosocial) understanding of their disease.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.