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. 2025 Mar 14:21:563-574.
doi: 10.2147/NDT.S510936. eCollection 2025.

Exploring Gender Differences in the Relationship Between Thyroid Function and Aggressive and Impulsive Behaviors in Patients with Major Depressive Disorder

Shuai Zhao  1   2   3   4 , Anzhen Wang  1   2   3   4 , Yuqin Han  1   2   3   4 , ChenXia Song  1   2   3   4 , Hongqin Zhang  1   2   3   4 , Kongliang He  1   2   3   4 , Juan Chen  1   2   3   4
Affiliations

Exploring Gender Differences in the Relationship Between Thyroid Function and Aggressive and Impulsive Behaviors in Patients with Major Depressive Disorder

Shuai Zhao et al. Neuropsychiatr Dis Treat. .

Abstract

Purpose: Major depressive disorder (MDD) is a widespread mental health condition with significant global impact. Exploring the gender differences in the interplay between thyroid function, aggression, and impulsivity offers valuable insights into its multifactorial nature and management.

Patients and methods: A cross-sectional study was conducted at Anhui Mental Health Center and included 113 MDD patients (56 males, 57 females) and 102 healthy controls (45 males and 57 females). Thyroid function was assessed through serum thyroid hormone levels, and impulsivity and aggression were measured using the Buss-Perry Aggression Questionnaire (BPAQ) and Barratt's Impulsiveness Scale version 11 (BIS). Potential confounding factors such as age, education, and Hamilton Depression Rating Scale (HAMD) scores were adjusted for.

Results: Both male and female MDD patients showed significant changes in serum thyrotropin levels (F(1,213)=10.996, p=0.001), impulsivity (F(1,213)=151.521, p<0.05), and aggression (F(1,213)=44.411, p<0.05) compared to healthy controls. MANCOVA revealed significant differences in attentional impulsivity, motor impulsivity, physical aggression, anger, hostility, and self-directed aggression (all p<0.05). Moreover, significant differences between genders were observed in these areas (all p<0.05). In males, TSH levels were inversely related to several behavioral dimensions (all p<0.05), while no such correlation was found in females.

Conclusion: This study highlights the role of thyroid function, especially TSH levels, in influencing impulsivity and aggression in male MDD patients, suggesting a gender-specific physiological-behavioral relationship. The findings contribute to the development of gender-specific treatment strategies. In the future, longitudinal studies with larger sample sizes should be conducted to explore molecular mechanisms for more personalized treatments.

Keywords: MDD; aggressive and impulsive; gender differences; thyroid function.

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Conflict of interest statement

The authors report no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The authors have also adhered to an excellent code of conduct and good ethical standards while conducting this study.

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