THYROID FUNCTION AND MENTAL HEALTH IN CHILDBEARING AGE WOMEN

Suryati Kumorowulan; Yusi Dwi Nurcahyani; Leny Latifah; Diah Yunitawati

doi:10.22435/mgmi.v13i1.5670

Suryati Kumorowulan Magelang Health Research and Development Center
Yusi Dwi Nurcahyani Magelang Health Research and Development Center
Leny Latifah Magelang Health Research and Development Center
Diah Yunitawati Magelang Health Research and Development Center

DOI: https://doi.org/10.22435/mgmi.v13i1.5670

Keywords: anxiety, depression, free T4, TSH

Abstract

Background. Thyroid dysfunction is frequently associated with psychiatric problems, such as anxiety or depression. On the other hand, thyroid dysfunction patients have little reason to be concerned about their mental health. Childbearing age women are included in the priority category because they require excellent health conditions to prepare for pregnancy and parenthood. Objective. This study aimed to investigate relationship between thyroid function (as evaluated by thyroid hormone levels and thyroid stimulating hormone (TSH) levels) with mental health in childbearing age women. Method. This study is a cross sectional study, with childbearing age women (aged 15 years and up) who are already menstruating but have not yet reached menopause. The research was conducted in Yogyakarta City and Bukittinggi City with a total sample of 487 people. This study’s independent variables were TSH and free T4 levels. The dependent variables were anxiety and depression. Other things to consider are height, body weight, and age. Blood samples had used to measure TSH and free T4 levels. All respondents were interviewed to assess whether they were depressed or anxious using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results. There is a significant difference in score of BAI (21.1±11,67 vs 19.7±11.18, p<0.000) and BDI (10.1±8.06 vs 9.50±7.36, p<0.000) between groups. Other results found that disfunction thyroid hormone levels (TSH <0.3 mIU/mL) was related to depression (OR 2.324 95% CI 1.072–5.041, p<0.05; AOR 2.718 95% CI 1.028–7.186, p<0.05), but not associated with anxiety. Conclusion. Thyroid dysfunction, particularly low thyroid stimulating hormone levels, has been linked to higher risk of depression in childbearing age women.

References

Medenica S, Nedeljkovic O, Radojevic N, Stojkovic M, Trbojevic B, Pajovic B. Thyroid Dysfunction and Thyroid Autoimmunity in Euthyroid Women in Achieving Fertility. Eur Rev Med Pharmacol Sci. 2015;19(6):977–87.

Taylor PN, Zouras S, Min T, Nagarahaj K, Lazarus JH, Okosieme O. Thyroid Screening in Early Pregnancy: Pros and Cons. Front Endocrinol (Lausanne). 2018;9:1–7.

Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550–62.

De Leo S, Lee SY, Braverman LE. Hyperthyroidism. Lancet. 2016;388(10047):906–18.

Moog NK, Entringer S, Heim C, Wadhwa PD, Kathmann N, Buss C. Influence of Maternal Thyroid Hormones during Gestation on Fetal Brain Development. Neuroscience. 2017;342:68–100.

Eligar V, Taylor P, Okosieme O, Dayan C. Thyroid Hormone Replacement. In: Pfaff D, Joëls M, editors. Hormones, Brain and Behavior, 3rd ed. Oxford: Academic Press; 2017. p. 229–39.

Kim EY, Kim SH, Rhee SJ, Huh I, Ha K, Kim J, et al. Relationship between Thyroid-Stimulating Hormone Levels and Risk of Depression among The General Population with Normal Free T4 Levels. Psychoneuroendocrinology. 2015;58:114–9.

Hage MP, Azar ST. The Link between Thyroid Function and Depression. J Thyroid Res. 2012;2012:590648.

Grigoriadis S, Robinson GE. Gender Issues in Depression. Ann Clin Psychiatry. 2007;19(4):247–55.

Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan. Laporan Nasional Riskedas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan; 2019.

Williams MD, Harris R, Dayan CM, Evans J, Gallacher J, Ben-Shlomo Y. Thyroid Function and The Natural History of Depression: Findings from The Caerphilly Prospective Study (CaPS) and A Meta-Analysis. Clin Endocrinol (Oxf). 2009;70(3):484–92.

Ittermann T, Völzke H, Baumeister SE, Appel K, Grabe HJ. Diagnosed Thyroid Disorders are Associated with Depression and Anxiety. Soc Psychiatry Psychiatr Epidemiol. 2015;50(9):1417–25.

Maes M, Meltzer HY, Cosyns P, Suy E, Schotte C. An Evaluation of Basal Hypothalamic-Pituitary-Thyroid Axis Function in Depression: Results of A Large-Scaled and Controlled Study. Psychoneuroendocrinology. 1993;18(8):607–20.

Romero-Gómez B, Guerrero-Alonso P, Carmona-Torres JM, Notario-Pacheco B, Cobo-Cuenca AI. Mood Disorders in Levothyroxine-Treated Hypothyroid Women. Int J Environ Res Public Health. 2019;16(23):4776.

Hong JW, Noh JH, Jun-Kim D. Association between Subclinical Thyroid Dysfunction and Depressive Symptoms in The Korean Adult Population: The 2014 Korea National Health and Nutrition Examination Survey. PLoS One. 2018;13(8):e0202258.

Engum A, Bjøro T, Mykletun A, Dahl AA. An Association between Depression, Anxiety and Thyroid Function--A Clinical Fact or An Artefact?. Acta Psychiatr Scand. 2002;106(1):27–34.

World Health Organization. Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide For Programme Managers. 3rd ed. Geneva: World Health Organization; 2007.

Kumorowulan S. Pengembangan Metode Alat Ukur Garam secara Kuantitatif di Daerah dengan Berbagai Tingkat Kecukupan Iodium. Laporan Penelitian. Magelang: Balai Penelitian dan Pengembangan Gangguan Akibat Kekurangan Iodium; 2017.

Departemen Kesehatan RI. Profil Kesehatan Indonesia. Jakarta: Departemen Kesehatan RI; 2009.

Carney CE, Moss TG, Harris AL, Edinger JD, Krystal AD. Should We be Anxious when Assessing Anxiety Using The Beck Anxiety Inventory in Clinical Insomnia Patients?. J Psychiatr Res. 2011;45(9):1243–9.

Alvi T, Assad F, Ramzan M KF. Depression, Anxiety and Their Associated Factors among Medical Students. J Coll Physicians Surg Pak. 2010;20(2):122–6.

Stohn JP, Martinez ME, Hernandez A. Decreased Anxiety and Depression Like Behaviors and Hyperactivity in A Type 3 Deiodinase-Deficient Mouse Showing Brain Thyrotoxicosis and Peripheral Hypothyroidism. Psychoneuroendocrinology. 2016;74:46–56.

Bathla M, Singh M, Relan P. Prevalence of Anxiety and Depressive Symptoms among Patients with Hypothyroidism. Indian J Endocrinol Metab. 2016;20(4):468–74.

Zimmermann MB. The Thyroid and Its Diseases. In: Luster M, Duntas LH, Wartofsky L, editors. The Thyroid and Its Diseases. A Comprehensive Guide for the Clinician. Cham: Springer International Publishing; 2019. p.101–108.

Almeida OP, Alfonso H, Flicker L, Hankey G, Chubb SAP, Yeap BB. Thyroid Hormones and Depression: The Health in Men Study. Am J Geriatr Psychiatry. 2011;19(9):763–70.

Varella AC, Benseñor IM, Janovsky CCPS, Goulart AC, Birck MG, Santos IS, et al. Thyroid Stimulating Hormone Levels and Incident Depression: Results from The ELSA-Brasil Study. Clin Endocrinol (Oxf). 2021;94(5):858–65.

Peltzer K, Pengpid S. High Prevalence of Depressive Symptoms in A National Sample of Adults in Indonesia: Childhood Adversity, Sociodemographic Factors and Health Risk Behaviour. Asian J Psychiatr. 2018;33:52–9.