Thyroid dysfunction and suicide attempt in major depressive disorder

  • Shen Y & al.
  • J Affect Disord
  • 20 Aug 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In major depressive disorder (MDD), suicide attempters were more likely to have severe anxiety symptoms, psychotic symptoms, higher serum levels of thyroid-stimulating hormone (TSH), anti-thyroglobulin (TgAb) and thyroid peroxidases antibody (TPOAb) level, suggesting that TSH, TgAb, and TPOAb may be promising biomarkers for suicide risk in MDD.

Why this matters

  • Findings suggest screening serum levels of TSH, TPOAb and TgAb to prevent suicide attempts in MDD patients.

Study design

  • Cross-sectional study of treatment-naïve patients with a diagnosis of MDD at their first episode (n=1718).
  • Psychotic, anxiety and depressive symptoms, were measured by the positive subscale of the Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD), respectively
  • Funding: The CAS Pioneer Hundred Talents Program and the National Natural Science Foundation of China.

Key results

  • Overall, 346 patients met the criteria for suicide attempters and 1372 patients did not.
  • Suicide attempters vs non-suicide attempters had greater scores on HAMD, HAMA and PANSS psychotic symptoms and had higher levels of:
    • TSH (OR, 2.39; 95% CI, 1.83-3.13; P<.001>
    • TgAb (OR, 2.76; 95% CI, 2.09-3.64; P<.001>
    • TPOAb (OR, 3.17; 95% CI, 2.47-4.07; P<.001>
  • Logistic regression analysis revealed that suicide attempts were associated with:
    • severe anxiety (aOR, 2.70; 95% CI, 1.76-4.13; P<.001>
    • TPOAb (aOR, 2.18; 95% CI, 1.57-3.04; P<.001>

Limitations

  • Causal relationship not determined because of the cross-sectional design