Estudo da prevalencia do hipotiroidismo subclinico e sua relação com depressão em pacientes idosos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2000

RESUMO

In order to investigate the association between subclinical hypothyroidism and depression, that still remains controvers~ we examined people over 60 years divided into three groups ofpatients. Group I consisted of252 patients (184 females, and 68 males) with high serum TSH levels. Group li was composed of 71 patients (45 females and 26 males) referred to psychiatry for depression. Group III consisted of203 patients (148 females and 55 males) with no previous diagnosis of thyroid or mood disease. Ali patients were clinically examined and classified according to CID-10 for mood disturbance and had serum TSH measured by sensitive assays (functional sensitivity of 0.05 mU/L, intra and interassay coefficient ofvariation 3.2% and 5.7%, respectively, and normal values ofO.38¬4.5 mU/L; Stratus-Baxter and Immulite, DPC). Free T4 levels were determined by fluorometric enzyme immunoassay (normal values: 0.74-2.0 ngldL; Stratus-Baxter and Immulite, DPC). High serum TSH levels (11.6+/-14.8 mU/L) were observed in 65/203 (32%) patients of the elder1y control population (group III). Among these patients, 42/65 (65%) had normal free T4 c~ncentrations (1.23+/-0.98 ngldL), no clinical manifestation of hypothyroidis~ and thus were considered to present subclinical hypothyroidism. Depression was observed in 124 patients and was more frequent in the subclinical (36/124: 29%) than in the clinical hypothyroid patients (24/124: 19%; Chi-square, p=0.001). Serum I TgAboand/or TPOAb (measured by an IRMA method; Serono Diagnostic) were positive in 18% ofthe control elder patients and in 14.5% ofthe depressed patients. Women that did not receive hormone therapy for menopause were also more frequent1y depressed, than those who did receive (Chi-square; p<0.001). The ROC curve analysis showed a sensitivity of 76% and specificity of 85% in the diagnosis of hypothyroidism when the serum TSH value was higher than 4.5 mU/L. Our results suggest TSH as well as mood disturbance screening should be periodically performed in people older than 60, especially in women who do not receive hormone therapy for menopause

ASSUNTO(S)

depressão em idosos tireoide

ACESSO AO ARTIGO

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