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Are Autoimmune Thyroid Dysfunction and Depression Related?¹

Department of Social and Behavioral Sciences, University of Tilburg (V.J.P.); Diagnostic Center Eindhoven (L.H.M., G.L.), Eindhoven; the Department of Clinical and Health Psychology, University of Utrecht (M.J.v.S.), Utrecht; and the Department of Family Medicine, University of Maastricht (A.A.K.), Maastricht, The Netherlands; the Departments of Immunology (A.M.W.) and Medicine (R.M., A.P.W.), University of Sheffield, Sheffield, United Kingdom S5-7AU

Address all correspondence and requests for reprints to: Victor J. Pop, M.D., Ph.D., Department of Social and Behavioral Science, University of Tilburg, P.O. Box 90153, 5000 LE Tilburg, The Netherlands.

The objective of this study was to examine the relationship between autoimmune thyroid disease and depression in perimenopausal women. Thyroid function [TSH, free T₄, and thyroid peroxidase antibodies (TPO-Ab)] and depression (using the Edinburgh Depression Scale) were assessed cross-sectionally together with other determinants of depression. The subjects were 583 randomly selected perimenopausal women (aged 47–54 yr) from a community cohort of 6846 women. The main outcome measures were the occurrence of thyroid dysfunction (abnormal free T₄ and/or TSH or elevated levels of TPO-Ab) and the concomitant presence of depression according to the Edinburgh Depression Scale. Neither biochemical thyroid dysfunction nor menopausal status was related to depression. Apart from several psycho-social determinants (the occurrence of a major life event, a previous episode of depression, or financial problems), an elevated level of TPO-Ab (100 U/mL) was significantly associated with depression (odds ratio, 3.0, 95% confidence interval, 1.3–6.8). We conclude that women with elevated TPO-Ab levels are especially vulnerable to depression, whereas postmenopausal status does not increase the risk of depression.

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