Subclinical thyroid dysfunction and major depressive disorder

doi:10.1007/s42000-021-00312-3

Review

. 2021 Dec;20(4):613-621.

doi: 10.1007/s42000-021-00312-3. Epub 2021 Aug 24.

Subclinical thyroid dysfunction and major depressive disorder

Grigorios N Karakatsoulis^{1

2}, Eva-Maria Tsapakis^{3

4}, Calypso Mitkani⁵, Konstantinos N Fountoulakis⁶

Affiliations

¹ 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University General Hospital AHEPA, Stilponos Kyriakidi Str. 1, Thessaloniki, Greece. gregkarakatsoulis@gmail.com.
² , Thessaloniki, Greece. gregkarakatsoulis@gmail.com.
³ 1st Department of Psychiatry, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 564 29, Thessaloniki, Greece.
⁴ "Agios Charalambos" Mental Health Clinic, 71305, Heraklion, Crete, Greece.
⁵ "Agios Pavlos" General Hospital, Ethnikis Antistaseos Ave. 161, Thessaloniki, Greece.
⁶ 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University General Hospital AHEPA, Stilponos Kyriakidi Str. 1, Thessaloniki, Greece.

PMID: 34427900
DOI: 10.1007/s42000-021-00312-3

Review

Subclinical thyroid dysfunction and major depressive disorder

Grigorios N Karakatsoulis et al. Hormones (Athens). 2021 Dec.

. 2021 Dec;20(4):613-621.

doi: 10.1007/s42000-021-00312-3. Epub 2021 Aug 24.

Authors

Grigorios N Karakatsoulis^{1

2}, Eva-Maria Tsapakis^{3

4}, Calypso Mitkani⁵, Konstantinos N Fountoulakis⁶

Affiliations

¹ 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University General Hospital AHEPA, Stilponos Kyriakidi Str. 1, Thessaloniki, Greece. gregkarakatsoulis@gmail.com.
² , Thessaloniki, Greece. gregkarakatsoulis@gmail.com.
³ 1st Department of Psychiatry, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 564 29, Thessaloniki, Greece.
⁴ "Agios Charalambos" Mental Health Clinic, 71305, Heraklion, Crete, Greece.
⁵ "Agios Pavlos" General Hospital, Ethnikis Antistaseos Ave. 161, Thessaloniki, Greece.
⁶ 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University General Hospital AHEPA, Stilponos Kyriakidi Str. 1, Thessaloniki, Greece.

PMID: 34427900
DOI: 10.1007/s42000-021-00312-3

Abstract

Purpose: This review attempts to investigate the link between subclinical thyroid dysfunction (SCH) and major depressive disorder (MDD). It has been speculated that SCH may be related to MDD through an autoimmune mechanism.

Methods: A comprehensive literature search was conducted in the PubMed database for relevant research and review articles.

Results: There appears to be an association between an autoimmune mechanism, possibly involving the thyroid gland, and depressive disorders, but the available evidence is so far inconclusive.

Conclusion: Lifetime prevalence of depression is significantly higher in patients with SCH, a finding reflecting a possible effect of SCH in lowering the threshold for the emergence of MDD. The relationship between SCH and MDD is, however, not clear, with large and well-designed studies investigating possible links between reference-range thyroid hormone levels and MDD having as yet found no relation between the two.

Keywords: Major depressive disorder; Psychoneuroendocrinology; Subclinical; Thyroid function.

PubMed Disclaimer

Cited by

Hypothyroidism and Depression: A Narrative Review.
Nuguru SP, Rachakonda S, Sripathi S, Khan MI, Patel N, Meda RT. Nuguru SP, et al. Cureus. 2022 Aug 20;14(8):e28201. doi: 10.7759/cureus.28201. eCollection 2022 Aug. Cureus. 2022. PMID: 36003348 Free PMC article. Review.
Exploring the Genetic Link Between Thyroid Dysfunction and Common Psychiatric Disorders: A Specific Hormonal or a General Autoimmune Comorbidity.
Soheili-Nezhad S, Sprooten E, Tendolkar I, Medici M. Soheili-Nezhad S, et al. Thyroid. 2023 Feb;33(2):159-168. doi: 10.1089/thy.2022.0304. Thyroid. 2023. PMID: 36463425 Free PMC article.
Association of four metalloids in the serum and urine of individuals with major depressive disorders: a case-control study.
He L, Li S, Huang Y, Zhu Y, Fan L, Zhang H, Hou X, Li X, Deng H, Guo X, Liu C, Hu C, Cao B. He L, et al. Front Psychiatry. 2024 Jun 12;15:1403852. doi: 10.3389/fpsyt.2024.1403852. eCollection 2024. Front Psychiatry. 2024. PMID: 38932939 Free PMC article.
Exploring Gender Differences in the Relationship Between Thyroid Function and Aggressive and Impulsive Behaviors in Patients with Major Depressive Disorder.
Zhao S, Wang A, Han Y, Song C, Zhang H, He K, Chen J. Zhao S, et al. Neuropsychiatr Dis Treat. 2025 Mar 14;21:563-574. doi: 10.2147/NDT.S510936. eCollection 2025. Neuropsychiatr Dis Treat. 2025. PMID: 40103619 Free PMC article.
Exploring the Relationship between Mood Disorders and Coexisting Health Conditions: The Focus on Nutraceuticals.
Mechlińska A, Wiglusz MS, Słupski J, Włodarczyk A, Cubała WJ. Mechlińska A, et al. Brain Sci. 2023 Aug 30;13(9):1262. doi: 10.3390/brainsci13091262. Brain Sci. 2023. PMID: 37759862 Free PMC article. Review.

See all "Cited by" articles

References

1. Loh HH, Lim LL, Yee A et al (2019) Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. BMC Psychiatry 19:12. https://doi.org/10.1186/s12888-018-2006-2 - DOI - PubMed - PMC
1. Cohen BM, Sommer BR, Vuckovic A (2018) Antidepressant-resistant depression in patients with comorbid subclinical hypothyroidism or high-normal TSH levels. Am J Psychiatry 175:598–604. https://doi.org/10.1176/appi.ajp.2017.17080949 - DOI - PubMed
1. Dwyer JB, Aftab A, Radhakrishnan R et al (2020) Hormonal treatments for major depressive disorder: state of the art. Am J Psychiatry 177(8):686–705. https://doi.org/10.1176/appi.ajp.2020.19080848
1. Le Donne M, Mento C, Settineri S et al (2017) Postpartum mood disorders and thyroid autoimmunity. Front Endocrinol (Lausanne) 8:91. https://doi.org/10.3389/fendo.2017.00091 - DOI
1. Hage MP, Azar ST (2012) The link between thyroid function and depression. J Thyroid Res 2012:590648. https://doi.org/10.1155/2012/590648 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

LinkOut - more resources

Full Text Sources
- Springer
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

[1] Loh HH, Lim LL, Yee A et al (2019) Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. BMC Psychiatry 19:12. https://doi.org/10.1186/s12888-018-2006-2 - DOI - PubMed - PMC

[2] Loh HH, Lim LL, Yee A et al (2019) Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. BMC Psychiatry 19:12. https://doi.org/10.1186/s12888-018-2006-2 - DOI - PubMed - PMC

[3] Cohen BM, Sommer BR, Vuckovic A (2018) Antidepressant-resistant depression in patients with comorbid subclinical hypothyroidism or high-normal TSH levels. Am J Psychiatry 175:598–604. https://doi.org/10.1176/appi.ajp.2017.17080949 - DOI - PubMed

[4] Cohen BM, Sommer BR, Vuckovic A (2018) Antidepressant-resistant depression in patients with comorbid subclinical hypothyroidism or high-normal TSH levels. Am J Psychiatry 175:598–604. https://doi.org/10.1176/appi.ajp.2017.17080949 - DOI - PubMed

[5] Dwyer JB, Aftab A, Radhakrishnan R et al (2020) Hormonal treatments for major depressive disorder: state of the art. Am J Psychiatry 177(8):686–705. https://doi.org/10.1176/appi.ajp.2020.19080848

[6] Dwyer JB, Aftab A, Radhakrishnan R et al (2020) Hormonal treatments for major depressive disorder: state of the art. Am J Psychiatry 177(8):686–705. https://doi.org/10.1176/appi.ajp.2020.19080848

[7] Le Donne M, Mento C, Settineri S et al (2017) Postpartum mood disorders and thyroid autoimmunity. Front Endocrinol (Lausanne) 8:91. https://doi.org/10.3389/fendo.2017.00091 - DOI

[8] Le Donne M, Mento C, Settineri S et al (2017) Postpartum mood disorders and thyroid autoimmunity. Front Endocrinol (Lausanne) 8:91. https://doi.org/10.3389/fendo.2017.00091 - DOI

[9] Hage MP, Azar ST (2012) The link between thyroid function and depression. J Thyroid Res 2012:590648. https://doi.org/10.1155/2012/590648 - DOI - PubMed

[10] Hage MP, Azar ST (2012) The link between thyroid function and depression. J Thyroid Res 2012:590648. https://doi.org/10.1155/2012/590648 - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Subclinical thyroid dysfunction and major depressive disorder

Affiliations

Subclinical thyroid dysfunction and major depressive disorder

Authors

Affiliations

Abstract

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous

Abstract

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Related information

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous