Depressão e hipotireoidismo: Uma revisão sistemática

Eduarda Silva Souza; Rosangela Soares Chriguer; Maria Cristina Mazzaia

doi:10.31211/rpics.2023.9.2.314

Autores

Eduarda Silva Souza Universidade Federal de São Paulo, Santos, Departamento de Biociência, (UNIFESP) https://orcid.org/0000-0002-1038-0364
Rosangela Soares Chriguer Universidade Federal de São Paulo https://orcid.org/0000-0003-1257-5496
Maria Cristina Mazzaia Universidade Federal de São Paulo, Santos, Departamento de Biociência, (UNIFESP) https://orcid.org/0000-0001-5259-577X

DOI:

https://doi.org/10.31211/rpics.2023.9.2.314

Palavras-chave:

Depressão, Hipotireoidismo, Transtorno Depressivo Maior, Transtornos neuroendócrinos, Revisão sistemática

Resumo

Contexto e Objetivo: Diante da prevalência global de transtornos depressivos e da associação potencial com condições neuroendócrinas como o hipotireoidismo, este estudo objetivou explorar a relação entre hipotireoidismo e depressão ou sintomas depressivos. Métodos: Utilizando as bases de dados PubMed, Embase e CAPES, seguindo a metodologia PRISMA, foram selecionados estudos publicados entre 2018 e 2022. Os critérios de inclusão abrangeram artigos em inglês, espanhol ou português, usando métodos diagnósticos variados, incluindo exames laboratoriais e entrevistas clínicas ou escalas psicológicas. Excluíram-se revisões, estudos em animais, entre outros tipos de publicações não primárias. A qualidade dos estudos foi avaliada pela Newcastle-Ottawa Scale. Resultados: Dos 14 artigos selecionados, emergiu uma associação significativa entre hipotireoidismo e depressão, particularmente em mulheres, incluindo aquelas em terapia de reposição hormonal. Todavia, os dados sobre a relação entre hipotireoidismo subclínico e depressão foram conflitantes. Adicionalmente, o hipotireoidismo como comorbidade no transtorno depressivo maior pode contribuir para desfechos clínicos graves. Conclusões: Esses resultados sugerem uma possível associação entre o hipotireoidismo e a depressão. Este achado realça a importância de avaliar a função tireoidiana em pacientes depressivos, especialmente mulheres, para um diagnóstico e tratamento eficazes, alinhados à prática clínica baseada em evidências.

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Referências

Airaksinen, J., Komulainen, K., García-Velázquez, R., Määttänen, I., Gluschkoff, K., Savelieva, K., & Jokela, M. (2021). Subclinical hypothyroidism and symptoms of depression: Evidence from the National Health and Nutrition Examination Surveys (NHANES). Comprehensive Psychiatry, 109, Artigo 152253. https://doi.org/gqp5kp

Almeida, M. M. R., Kuwae, A. S., Quirino, C. M. J., Gondim, L. V., & Silva, D. O. F. (2013). A depressão e sua relação com o hipotireoidismo. Revista de Medicina e Saúde de Brasília, 2(3), 164–169. https://bit.ly/3Rm2IRb

Altshuler, L. L., Bauer, M., Frye, M. A., Gitlin, M. J., Mintz, J., Szuba, M. P., Leight, K. L., & Whybrow, P. C. (2001). Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. The American Journal of Psychiatry, 158(10), 1617–1622. https://doi.org/dqf38j

American Psychiatry Association. (2014). Manual diagnóstico e estatístico de transtornos mentais (5.ª ed.). Artmed.

Bauer, M., Heinz, A., & Whybrow, P. C. (2002). Thyroid hormones, serotonin and mood: Of synergy and significance in the adult brain. Molecular Psychiatry, 7(2), 140–156. https://doi.org/b83vvz

Bauer, M., & Whybrow, P. C. (2021). Role of thyroid hormone therapy in depressive disorders. Journal of Endocrinological Investigation, 44(11), 2341–2347. https://doi.org/k56v

Beck, A., Crain, A. L., Solberg, L. I., Unützer, J., Glasgow, R. E., Maciosek, M. V., & Whitecird, R. (2011). Severity of depression and magnitude of productivity loss. The Annals of Family Medicine, 9(4) 305–311. https://doi.org/bkf3hg

Bitencourt, F. V., Oliveira, L. B., Massignan, C., Stefani, C. M., & Canto, G. D. L. (2021). Análise da qualidade metodológica de estudos observacionais (coorte e caso-controle) com a ferramenta Newcastle-Ottawa Scale (NOS). Em G. de Luca Canto, C. Miron Stefani, & C. Massignan (Eds.), Risco de viés em revisões sistemáticas: guia prático (Cap. 10). Centro Brasileiro de Pesquisas Baseadas em Evidências – COBE UFSC. https://bit.ly/3uxyhyy

Bode, H., Ivens, B., Bschor, T., Schwarzer, G., Henssler, J., & Baethge, C. (2021). Association of hypothyroidism and clinical depression: A systematic review and meta-analysis. JAMA Psychiatry, 78(12), 1375–1383. https://doi.org/gqqwg4

Chang, B. P., Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., & Nock, M. K. (2016). Biological risk factors for suicidal behaviors: A meta-analysis. Translational Psychiatry, 6(9), Artigo e887. https://doi.org/f9ccmq

Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: Where we’ve been and where we’re going. Advances in Therapy, 36, 47–58. https://doi.org/ghnggk

Choi, K. W., Kim, Y., Fava, M., Mischoulon, D., Na, E. J., Kim, S. W., Shin, M.-H., Chung, M. K., & Jeon, H. J. (2019). Increased morbidity of major depressive disorder after thyroidectomy: A nationwide population-based study in South Korea. Thyroid, 29(12), 1713–1722. https://doi.org/k56z

Fugger, G., Dold, M., Bartova, L., Kautzky, A., Souery, D., Mendlewicz, J., Serretti, A., Zohar, J., Montgomery, S., Frey, R., & Kasper, S. (2018). Comorbid thyroid disease in patients with major depressive disorder-results from the European Group for the Study of Resistant Depression (GSRD). European Neuropsychopharmacology, 28(6), 752–760. https://doi.org/gdt285

Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber, K. (2012). Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice, 18(6), 988–1028. https://doi.org/gbcfsn

Gorkhali, B., Sharma, S., Amatya, M., Acharya, D., & Sharma, M. (2020). Anxiety and depression among patients with thyroid function disorders. Journal of Nepal Health Research Council, 18(3), 373–378. https://doi.org/k562

Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H., Kessler, R. C. (2021). The economic burden of adults with major depressive disorder in the United States (2010 and 2018). PharmacoEconomic, 39, 653–665. https://doi.org/gnwsqc

Gunes, N. A. (2020). Evaluation of anxiety and depression in patients with thyroid function disorder. Revista da Associação Médica Brasileira, 66(7), 979–985. https://doi.org/k563

Hage, M. P., & Azar, S. T. (2012). The link between thyroid function and depression. Journal of Thyroid Research, 2012, Artigo 590648. https://doi.org/c6bzfn

Herzog, R., Álvarez-Pasquin, M., Díaz, C., Del Barrio, J. L., Estrada, J. M., & Gil, Á. (2013). Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health, 13(1), 1–17. https://doi.org/gbczmv

Hong, J. W., Noh, J. H., & Kim, D. J. (2018). Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey. PLoS One, 13(8), Artigo e0202258. https://doi.org/k564

Kafle, B., Khadka, B., & Tiwari, M. L. (2020). Prevalence of thyroid dysfunction among depression patients in a tertiary care centre. Journal of the Nepal Medical Association, 58(229), Artigo 654. https://doi.org/k565

Kamyshna, I., Pavlovych, L., & Kamyshnyi, A. M. (2022). Prediction of the development of depression in patients with autoimmune thyroiditis and hypothyroidism. Open Access Macedonian Journal of Medical Sciences, 10(B), 137–145. https://doi.org/k566

Kim, J. S., Zhang, Y., Chang, Y., Ryu, S., Guallar, E., Shin, Y. C., Shin, H., Lim, S.-W., & Cho, J. (2018). Subclinical hypothyroidism and incident depression in young and middle-age adults. The Journal of Clinical Endocrinology & Metabolism, 103(5), 1827–1833. https://doi.org/k567

Kim, M. D., Yang, H. J., Kang, N. R., Park, J. H., & Jung, Y. E. (2020). Association between subclinical hypothyroidism and metabolic syndrome among individuals with depression. Journal of Affective Disorders, 264, 494–497. https://doi.org/grzrvb

Kim, W. B., Woo, G., Kim, H., Cho, Y., Kim, T. Y., Kim, S. W., Shin, M.-H., Park, J. W., Park, H.-L., Oh, K., & Chung, J. H. (2017). Thyroid stimulating hormone reference range and prevalence of thyroid dysfunction in the Korean population: Korea National Health and Nutrition Examination Survey 2013 to 2015. Endocrinolology and Metabolism, 32(1), 106–114. https://doi.org/k568

Kuehner, C. (2017). Why is depression more common among women than among men? The Lancet. Psychiatry, 4(2), 146–158. https://doi.org/f9r4q7

Lang, X., Hou, X., Shangguan, F., & Zhang, X. Y. (2020). Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese. Journal of Affective Disorders, 263, 507–515. https://doi.org/gqtxv7

Loh, H. H., Lim, L. L., Yee, A., & Loh, H. S. (2019). Association between subclinical hypothyroidism and depression: An updated systematic review and meta-analysis. BMC Psychiatry, 19(1), Artigo 12. https://doi.org/ggxc3g

Selçuk, A. A. (2019). A guide for systematic reviews: PRISMA. Turkish Archives of Otorhinolaryngology, 57(1), 57–58. https://doi.org/k569

Shen, Y., Wu, F., Zhou, Y., Ma, Y., Huang, X., Ning, Y., Lang, X., Luo, X., & Zhang, X. (2019). Association of thyroid dysfunction with suicide attempts in first-episode and drug naïve patients with major depressive disorder. Journal of Affective Disorders, 259, 180–185. https://doi.org/gjg782

Taylor, P. N., Albrecht, D., Scholz, A., Gutierrez-Buey, G., Lazarus, J. H., Dayan, C. M., & Okosieme, O. E. (2018). Global epidemiology of hyperthyroidism and hypothyroidism. Nature Reviews Endocrinology, 14(5), 301–316. https://doi.org/gc724p

Toloza, F. J. K., Mao, Y., Menon, L., George, G., Borikar, M., Thumma, S., Motahari, H., Erwin, P., Owen, R., & Maraka, S. (2021). Association of thyroid function with suicidal behavior: A systematic review and meta-analysis. Medicina, 57(7), Artigo 714. https://doi.org/k56w

Wells, G. A., Shea, B., O'Connell, D., Peterson, J., Welch, V., Losos, M., & Tugwell, P. (2014). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. The Ottawa Hospital Research Institute. https://bit.ly/47B5vM7

Wildisen, L., Giovane, C. D., Moutzouri, E., Beglinger, S., Syrogiannouli, L., Collet, T. H., Cappola, A. R., Åsvold, B. O., Bakker, S. J. L., Yeap, B. B., Almeida, O. P., Ceresini, G., Dullaart, R. P. F., Ferrucci, L., Grabe, H., Jukema, J. W., Nauck, M., Trompet, S., Völzke, H., ... Rodondi, N. (2020). An individual participant data analysis of prospective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms. Scientific Reports, 10(1), 1–12. https://doi.org/gjw3vw

World Health Organization. (‎2017)‎. Depression and other common mental disorders: Global health estimates. https://bit.ly/3sYK6h2

Yuan, L., Luan, D., Xu, X., Yang, Q., Huang, X., Zhao, S., Zhang, Y., & Zhou, Z. (2020). Altered attention networks in patients with thyroid dysfunction: A neuropsychological study. Hormones and Behavior, 121, Artigo 104714. https://doi.org/k56x

Zhao, S., Chen, Z., Wang, X., Yao, Z., & Lu, Q. (2021). Increased prevalence of subclinical hypothyroidism in female hospitalized patients with depression. Endocrine, 72(2), 479–485. https://doi.org/gmq72t

Zhou, Y., Ma, Y., Wu, Q., Wang, Q., Yang, W. F. Z., Wang, Y., Yang, D., Luo, Y., Tang, K., Liu, T., & Wang, D. (2021). Comparison of thyroid hormone levels between patients with major depressive disorder and healthy individuals in China. Frontiers in Psychiatry, 12, Artigo 750749. https://doi.org/k57b