Prevalence of depression in patients affected by subclinical hypothyroidism

Abstarct AIM: The aim of this study was to estimate the prevalence of depressive symptoms in patints affected by subclinical hypotyroidism bu means of Hamilton Rating Scale for Deopression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS); to assess which depressive symptoms are prevalent in our population, with references to the factorialization of HAM-D by CLeary and Guy (1977); to verify whether levothyroxine repalcement therapy alone can induce total remission of depressive symptoms. METHODS: The study enrolled 63 patinets affected by subclinical hypothyroidism undergoing follow-up at the endocrinology servive of San Paolo Hospital in Milan. Alla patients underwent an evaluation by means of HAM-D and MADRS scales and serum TSH, free T4, free T3, TPO-Ab and Tg-Ab level were measured. RESULTS: We estimetd a prevalence of depressive symptoms in our population of 63.5. Concerning the qualitative assessment of psychiatric disturbances in the population we considered, our results showed that the most freequent symptoms were part of four factors, according to Cleary and Guy factorialization of HAM-D: these disturbances (factor III), psychomotor retardation (factor V) and sleep disorders (factor IV). Levothyroxine replacement therapy alone wasn''t effective in including total remission of depressive symptoms. CONCLUSION: This study suggests the importance of a psychiatric evaluation in patients affected by subclinical hypothyroidism.