Poor prognosis for depression linked to an autoimmune thyroid condition?

John H. johnh at faraway.hgmp.mrc.ac.uk
Mon Mar 15 07:31:14 EST 2004

15/03/04 10:29PM

Public release date: 14-Mar-2004

Contact: Gemma Bradley
press at biomedcentral.com (mailto:press at biomedcentral.com)
BioMed Central (http://www.biomedcentral.com)
Poor prognosis for depression linked to an autoimmune thyroid condition?
Whether depression is linked to having an under-active thyroid gland has
been debated for many years. Research published in BMC Psychiatry this week
suggests that some patients with depression may be suffering from a subtle
autoimmune thyroid condition, which could hinder their recovery.
The study also suggests that physicians could use indicators of thyroid
function to predict patients' responsiveness to antidepressants. As
inpatients with depression often undergo routine thyroid tests, the data
that physicians would need to create such a prediction are likely to be
available to them already.
Researchers from Greece studied 30 patients suffering from major depression,
and 60 healthy people as controls. Each patient was examined by two
psychiatric experts, who assessed their condition during a structured
interview. The researchers then tested the thyroid function of all the
Although the levels of the thyroid function indicators FT3, FT4 and TSH,
fell inside the normal range for all the people studied, suffering from
depression appeared to increase the level of thyroid binding inhibitory
immunoglobulins in the blood of some patients. High levels of these
immunoglobulins can subtly inhibit the function of the thyroid gland.
The authors write: "Although thyroid dysfunction is not common in depression
there is evidence suggesting the presence of an underlying autoimmune
process affecting the thyroid gland in depressive patients.The finding that
depression often co-exists with autoimmune subclinical thyroiditis suggests
that depression may cause alterations in the immune system, or that in fact
it is an autoimmune disorder itself."
Two years after the initial examination, the patients were re-assessed, to
find out how well they had responded to treatment for their condition. The
patients' responsiveness was associated with the levels of thyroid hormone
and thyroid binding inhibitory immunoglobulin in their blood.
By creating an algorithm based on the indicators of thyroid function, the
researchers were able to predict patients' response to antidepressants with
an almost 90% success rate. Higher immunoglobulin levels were associated
with a reduced responsiveness to treatment, indicating that specific
therapeutic intervention could be needed to help these patients to recover.
Indicators of thyroid function could also be used as a diagnostic tool. When
plugged into a different algorithm, they predicted which patients were
suffering from depression in 80% of cases.
As the size of this study is relatively small, further research will be
necessary to confirm these findings, and to understand whether the thyroid
condition is the cause of the depression or vice versa.
This study is based on the following article:
Thyroid function in clinical subtypes of major depression: An exploratory
study Konstantinos N Fountoulakis, Apostolos Iacovides, Philippos
Grammaticos, George Kaprinis, Per Bech This will appear in BMC Psychiatry
2004, 4 on Monday 15 March.
When published this article will be available free of charge according to
BMC Psychiatry's open access policy via:
For further information about this research contact the author Dr.
Konstantinos N Fountoulakis by phone on 30-310-994-622 or by email at
kfount at med.auth.gr (mailto:kfount at med.auth.gr).
Alternatively, or for more information about the journal or Open Access,
contact Gemma Bradley by phone on 44-0-20-7323-0323 or by email at
press at biomedcentral.com (mailto:press at biomedcentral.com).
BMC Psychiatry (http://www.biomedcentral.com/bmcpsychiatr) is published by
BioMed Central (http://www.biomedcentral.com), an independent online
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