Universität zu Köln

Bode, Henry ORCID: 0000-0002-7515-6996, Ivens, Beatrice, Bschor, Tom, Schwarzer, Guido ORCID: 0000-0001-6214-9087, Henssler, Jonathan ORCID: 0000-0001-8123-5853 and Baethge, Christopher (2021). Association of Hypothyroidism and Clinical Depression A Systematic Review and Meta-analysis. JAMA Psychiatry, 78 (12). S. 1375 - 1384. CHICAGO: AMER MEDICAL ASSOC. ISSN 2168-6238

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Abstract

IMPORTANCE Hypothyroidism is considered a cause of or a strong risk factor for depression, but recent studies provide conflicting evidence regarding the existence and the extent of the association. It is also unclear whether the link is largely due to subsyndromal depression or holds true for clinical depression. OBJECTIVE To estimate the association of hypothyroidism and clinical depression in the general population. DATA SOURCES PubMed, PsycINFO, and Embase databases were searched from inception until May 2020 for studies on the association of hypothyroidism and clinical depression. STUDY SELECTION Two reviewers independently selected epidemiologic and population-based studies that provided laboratory or International Statistical Classification of Diseases and Related Health Problems diagnoses of hypothyroidism and diagnoses of depression according to operationalized criteria (eg, Diagnostic and Statistical Manual of Mental Disorders or International Statistical Classification of Diseases and Related Health Problems) or cutoffs in established rating scales. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and evaluated studies based on the Newcastle-Ottawa Scale. Summary odds ratios (OR) were calculated in random-effects meta-analyses. MAIN OUTCOMES AND MEASURES Prespecified coprimary outcomeswere the association of clinical depression with either hypothyroidism or autoimmunity. RESULTS Of 4350 articles screened, 25 studies were selected formeta-analysis, including 348 014 participants. Hypothyroidism and clinical depression were associated (OR, 1.30 [95% CI, 1.08-1.57]), while the OR for autoimmunity was inconclusive (1.24 [95% CI, 0.89-1.74]). Subgroup analyses revealed a stronger association with overt than with subclinical hypothyroidism, with ORs of 1.77 (95% CI, 1.13-2.77) and 1.13 (95% CI, 1.01-1.28), respectively. Sensitivity analyses resulted in more conservative estimates. In a post hoc analysis, the association was confirmed in female individuals (OR, 1.48 [95% CI, 1.18-1.85]) but not in male individuals (OR, 0.71 [95% CI, 0.40-1.25]). CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, the effect size for the association between hypothyroidism and clinical depression was considerably lower than previously assumed, and the modest association was possibly restricted to overt hypothyroidism and female individuals. Autoimmunity alone may not be the driving factor in this comorbidity.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bode, Henry UNSPECIFIED orcid.org/0000-0002-7515-6996 UNSPECIFIED Ivens, Beatrice UNSPECIFIED UNSPECIFIED UNSPECIFIED Bschor, Tom UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarzer, Guido UNSPECIFIED orcid.org/0000-0001-6214-9087 UNSPECIFIED Henssler, Jonathan UNSPECIFIED orcid.org/0000-0001-8123-5853 UNSPECIFIED Baethge, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-590007
DOI:	10.1001/jamapsychiatry.2021.2506
Journal or Publication Title:	JAMA Psychiatry
Volume:	78
Number:	12
Page Range:	S. 1375 - 1384
Date:	2021
Publisher:	AMER MEDICAL ASSOC
Place of Publication:	CHICAGO
ISSN:	2168-6238
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THYROID-STIMULATING HORMONE; SUBCLINICAL HYPOTHYROIDISM; DISORDERS; AUTOIMMUNITY; POPULATION; DYSFUNCTION; PREVALENCE; SYMPTOMS; COMORBIDITY; THERAPY Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59000