Lower levels of certain thyroid hormones may predict a poor treatment response in people hospitalized with depression, a study in the Journal of Affective Disorders suggests.
Zhifen Liu, M.D., of First Hospital of Shanxi Medical University in Taiyuan, China, and colleagues studied data from 2,086 patients who were admitted to the hospital with depression between 2014 and 2020. All patients received thyroid function evaluation—including assessments of serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH)—the morning after they were admitted. The patients’ depression symptoms were measured using the Hamilton Depression Rating Scale (HAM-D). The researchers analyzed changes in the patients’ HAM-D scores from the time of admission to discharge. Treatments during hospitalization varied by patient but included pharmacotherapy, repetitive transcranial magnetic stimulation, and/or psychotherapy.
After controlling for the patients’ age, education level, and other factors, the researchers found that lower levels of FT4 on admission were significantly associated with higher HAM-D scores, and lower levels of FT3 on admission were significantly associated with longer stays in the hospital—even when the levels of these hormones were within the normal range. The researchers also found that higher FT4 levels on admission were associated with greater improvements in HAM-D scores over the course of treatment between admission and discharge.
“[T]his study quantified the effectiveness and contribution of thyroid hormones in predicting the clinical outcomes of depression,” Liu and colleagues wrote. “[F]uture research can confidently explore deeper insights into endocrinology data, especially thyroid hormones, of depressed patients and [explore] more robust prediction models for predicting the response to antidepressant treatment in the real-word setting.”
For related information, see the American Journal of Psychiatry article “Hormonal Treatments for Major Depressive Disorder: State of the Art.”
(Image: iStock/Rasi Bhadramani)
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