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      SAT-457 The Association Between Thyroid Stimulating Hormone and Severe Depression: A Historical Cohort Study

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          Abstract

          Introduction: Hypothyroidism is implicated in the pathophysiology and clinical course of mood disorders. This study aimed to investigate the association between TSH and severe depression.

          Methods: The historical cohort included all consecutive adult patients (≥ 18 years) who had a TSH and PHQ-9 questionnaire data within 6 months of index visit, between October 2016 and July 2019, at the University of Utah Health. Data on demographics, hypothyroidism, TSH, PHQ-9, thyroid hormone replacement (THR), and antidepressant medications were extracted electronically. T-test and chi-square were used to compare continuous and categorical variables respectively. Logistic regression and one-way ANOVA were used to evaluate the association between TSH and depression severity. A sub-group analysis was performed among mood disorder patients without a diagnosis of overt hypothyroidism, comparing euthyroid patients (TSH 0.3-4) and patients with sub-clinical hypothyroidism based on TSH 4-10.

          Results: The cohort included 26,722 patients, mean age 46.3 years, 79.5% Caucasian, 68% females, and mean BMI 30. Mean PHQ-9 score was 8.2, 10% patients had severe depression (PHQ-9 ≥20), and 51% were on antidepressants and 26% on mood stabilizers. Mean TSH was 2.85, 19% patients had a diagnosis of hypothyroidism, and 20% patients were on THR. Patients with severe depression were more likely to have a higher mean TSH (p=0.06), be on antidepressants (p= <0.0001), and have a higher BMI (p=0.0003). There was a positive correlation between TSH and PHQ-9 score (p= 0.04). TSH was associated with severe depression, odds ratio 1.006 (1.003-1.009), after adjusting for potential co-variates. Hypothyroid patients who were on THR had a lower mean PHQ-9 score (p= <0.0001) as compared to hypothyroid patients not on THR. Patients with TSH from 7-10 had a higher PHQ-9 score as compared to those who had a TSH from 4-7 (p= <0.003).

          Conclusion: Severe depression was associated with higher TSH. Subclinical hypothyroidism with TSH above 50 th percentile was associated with higher PHQ-9 scores. Future RCTs should evaluate the effect of THR in (a) patients with severe depression and (b) patients with mood disorders who have subclinical hypothyroidism.

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          Author and article information

          Journal
          J Endocr Soc
          J Endocr Soc
          jes
          Journal of the Endocrine Society
          Oxford University Press (US )
          2472-1972
          08 May 2020
          08 May 2020
          08 May 2020
          : 4
          : Suppl 1 , ENDO 2020 ABSTRACTS SCHEDULED FOR THE ANNUAL MEETING OF THE ENDOCRINE SOCIETY – MARCH 28 – 31, 2020 - SAN FRANCISCO, CALIFORNIA (CANCELLED)
          : SAT-457
          Affiliations
          [1 ] University of Utah, Salt Lake City , UT, USA
          [2 ] Mayo Clinic , Rochester, MN, USA
          Article
          bvaa046.1581
          10.1210/jendso/bvaa046.1581
          7207901
          a6292d2b-61a1-441c-84a5-210ceaf3f7e5
          © Endocrine Society 2020.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

          History
          Page count
          Pages: 1
          Categories
          Thyroid
          Hpt-Axis and Thyroid Hormone Action
          AcademicSubjects/MED00250

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