Graves' disease and mental disorders

Atsushi Fukao, Junta Takamatsu, Takeshi Arishima, Mika Tanaka, Toshio Kawai, Yasuki Okamoto, Akira Miyauchi, Akihisa Imagawa, Atsushi Fukao, Junta Takamatsu, Takeshi Arishima, Mika Tanaka, Toshio Kawai, Yasuki Okamoto, Akira Miyauchi, Akihisa Imagawa

Abstract

Mental disorders merge highly with thyroid diseases. Because of its regulatory effects on serotonin and noradrenalin, T3 has been linked closely to depression and anxiety. It has known that in many cases, the mental symptoms persist even after normalization of thyroid function by treatment. Psychosocial factors including stress have been associated with mental symptoms even after thyroid function normalization in Graves' disease and a combination of mental disorders have been related to the exacerbation of hyperthyroidism. These findings suggest that psychosomatic approaches based on the bio-psycho-social medical model are important for the treatment of mental disorders associated with Graves' disease.

Keywords: Anxiety disorder; Depressive disorder; Eating disorder; Graves’ disease; Mental disorder; Stress.

© 2019 Published by Elsevier Inc.

Figures

Fig. 1
Fig. 1
Comparison of the psychiatric outlook of “Basedow psychosis” between Mayo Clinic (1920–1931) and Ito hospital (1975–1979). Cited from reference .
Fig. 2
Fig. 2
Comparison of clinical scales of MMPI among the three groups of subjects. The data are shown as mean of T-scores in MMPI. T-scores (deviation scores) express the psychiatric tendency by each clinical scales. Table cited from reference was modified to figure. Hs (hypochondriasis), D (depression), Hy (conversion hysteria), Pd (psychopathic deviation), Mf (masculity and feminity), Pa (paranoia), Pt (psychastenia), Sc (schizophrenia), Ma (hypomania), Si (social introversion).
Fig. 3
Fig. 3
Changes in the depressive personality of Graves’ disease patients before and during treatment. Depressive personality patients show T-scores (deviation scores) for hypochondriasis, depression or psychasthenia greater than 60 points in the MMPI. GroupA: depressive personality was present before and persisted after treatment. GroupB: depressive personality scores became higher after treatment. GroupC: depressive personality was present before treatment and decreased to within the normal range after treatment GroupD: depressive personality did not appear either before or after treatment. Cited from reference .
Fig. 4
Fig. 4
Comparison of the prognosis of hyperthyroidism between the depression and non-depression groups. The data from each group are shown as mean ± SD. The gray zone expresses the normal range. Significant difference: *P t-test. Remission rate: depressive group 22% (5/23) vs non-depressive group 52% (13/25) (P < 0.05 using the chi-square test). Cited from reference .

References

    1. Bauer M., Samuels M.H., Whybrow P.C. Behavioral and psychiatric aspects of thyrotoxicosis. In: Braverman L.E., Daniel D.S., editors. Werner and Ingbar’s the thyroid: a fundamental and clinical text. 10th ed. Lippincott-Raven Publishers; Philadelphia: 2013. pp. 475–480.
    1. Rouchell A.M., Pouns R., Tierney J.G. Depression. In: Wise M.G., Rundell J.R., editors. Textbook of consultation-liaison psychiatry. Psychiatry in the medically ill. 2nd ed. American Psychiatric Publishing; Washington, DC: 2002. pp. 307–338.
    1. Engel G.L. The need for new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–136.
    1. Kendler K.S., Gardner C.O. Depressive vulnerability, stressful life events and episode onset of Major depression: a longitudinal model. Psychol Med. 2016;46(9):1865–1874. Epub 2016 Mar 15.
    1. Den Boe J.A. Looking beyond the monoamine hypothesis. Eur Neurol Rev. 2006;6:87–92.
    1. Kirkegaard C., Faber J. The role of thyroid hormones in depression. Eur J Endocrinol. 1998;138:1–9.
    1. Mason G.A., Walker C.H., Plange A.J., Jr L-triiodothyronine:is this peripheral hormone a central neurotransmitter? Neuropsychopharmacology. 1993;8:253–257.
    1. Aronson R., Offman H.J., Joffe R.T. Triiodothyronine augmentation in the treatment of refractory depression: a meta-analysis. Arch Gen Psychiatry. 1996;53:842–848.
    1. Rubinow D.R., Gold P.W., Post R.M., Ballenger J.C., Cowdry R., Bollinger J. CSF somatostatin in affective illness. Arch Gen Psychiatry. 1983;40:377–386.
    1. Hage M.P., Azar S.T. The link between thyroid function and depression. J Thyroid Res. 2012;2012:1–8.
    1. Jackson I. The thyroid axis and depression. Thyroid. 1998:951–956.
    1. Hindal J.T., Kaplan M.M. Inhibition of thyroxine 5’-deiodination Type Ⅱ in cultured human placental cells by cortisol, insulin, 3,5’-cyclic adenosine monophosphate and butyrate. Metab Clin Exp. 1988;37:664–668.
    1. Hatterer J.A., Herbert J., Hidaka C., Roose S.P., Gorman J.M. CSF tranthyretin in patients with depression. Am J Psychiat. 1993;150:813–815.
    1. Fukao A., Takamatsu J., Ito M., Arishima T., Yokoyama H., Tanaka M. Thyroid hormone and mental diseases. J Jpn Thyroid Assoc. 2017
    1. Parry C.H. Vol. 2. Underwoods; London: 1825. (Collections from the unpublished writings of the late C.H.Parry).
    1. Graves R.J. Newly observed affection of the thyroid gland in females. Lond Med Surg J. 1835;7:516.
    1. Major R.H. Charles C Thomas; Splingfield, IL: 1959. Classic descriptions of disease; p. 45.
    1. Ritchie M., Yeap B.B. Thyroid hormone: Influences on mood and cognition in adults. Maturitas. 2015;81(2):266–275.
    1. Kathol R.G., Delahunt J.W. The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria. Gen Hosp Psychiatry. 1986 Jan;8(1):23–28.
    1. Katohl R.G., Turner R., Delahunt J. Depression and anxiety associated with hyperthyroidism:response to antithyroid therapy. Psychosomatics. 1986;27:501–505.
    1. Trzepacz P.T., Klein I., Roberts M., Greenhouse J., Levey G.S. Graves’ disease: an analysis of thyroid hormone levels and hyperthyroid signs and symptoms. Am J Med. 1989 Nov;87(5):558–561.
    1. Trzepacz P.T., McCue M., Klein I., Greenhouse J., Levey G.S. Psychiatric and neuropsychological response to propranolol in Graves’ disease. Biol Psychiatry. 1988;23(7):678–688.
    1. Gulseren S., Gulseren L., Hekimsoy Z., Cetinay P., Ozen C., Tokatlioglu B. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Arch Med Res. 2006;37(1):133–139.
    1. Fornaro M., Iovieno N., Clementi N., Boscaro M., Paggi F., Balercia G. Diagnosis of co-morbid axis-I psychiatric disorders among women with newly diagnosed, untreated endocrine disorders. World J Biol Psychiatry. 2010;11(8):991–996. Epub 2010 Jun 22.
    1. Chattopadhyay C., Chakrabarti N., Ghosh S. An assessment of psychiatric disturbances in Graves’ disease in a medical college in eastern India. Niger J Clin Pract. 2012;15(3):276.
    1. Hu L.Y., Shen C.C., Hu Y.W., Chen M.H., Tsai C.F., Chiang H.L. Hyperthyroidism and risk for bipolar disorders: a nationwide population-based study. PLoS One. 2013;8(8):e73057. eCollection 2013.
    1. Wu E.L., Chien I.C., Lin C.H., Chou Y.J., Chou P. Increased risk of hypothyroidism and hyperthyroidism in patients with major depressive disorder: a population-based study. J Psychosom Res. 2013 Mar;74(3):233–237. Epub 2013 Jan 22.
    1. Brandt F., Thvilum M., Almind D., Christensen K., Green A., Hegedüs L. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study. Eur J Endocrinol. 2013;170(2):341–348. Print 2014 Feb.
    1. Stern R.A., Robinson B., Thorner A.R., Arruda J.E., Prohaska M.L., Prange A.J., Jr. A survey study of neuropsychiatric complaints in patients with Graves’ disease. J Neuropsychiatry Clin Neurosci. 1996;8(2):181–185.
    1. Fahrenfort J.J., Wi1terdink A.M.L., van der Veen E.A. Long-term residual complaints and psychological sequate after remission of hyperthyroidism. Psychoneuroimmunology. 2000;25:201–211.
    1. Elberling T.V., Rasmussen A.K., Feldt-Rasmussen U., Hørding M., Perrild H., Waldemar G. Impaired health-related quality of life in Graves’ disease. A prospective study. Eur J Endocrinol. 2004 Nov;151(5):549–555.
    1. Thomsen A.F., Kvist T.K., Andersen P.K., Kessing L.V. Increased risk of affective disorder following hospitalisation with hyperthyroidism - a register-based study. Eur J Endocrinol. 2005 Apr;152(4):535–543.
    1. Thomsen A.F., Kessing L.V. Increased risk of hyperthyroidism among patients hospitalized with bipolar disorder. Bipolar Disord. 2005 Aug;7(4):351–357.
    1. Lee I.T., Sheu W.H., Liau Y.J., Lin S.Y., Lee W.J., Lin C.C. Relationship of stressful life events, anxiety and depression to hyperthyroidism in an Asian population. Horm Res. 2003;60(5):247–251.
    1. Engum A., Bjøro T., Mykletun A. Dahl AA An association between depression, anxiety and thyroid function-a clinical fact or an artifact? Arch Psychiatr Scand. 2002;106:27–34.
    1. Panicker V., Evans J., Bjøro T., Asvold B.O., Dayan C.M., Bjerkeset O. A paradoxical difference in relationship between anxiety, depression and thyroid function in subjets on and not on T4: findings from the HUNT study. Clin Endocrinol (Oxf) 2009;70:484–492.
    1. Bunevicius R., Prange A.J., Jr Thyroid disease and mental disorders: cause and effect or only comorbidity? Curr Opin Psychiatry. 2010;23:363–368.
    1. Fujinami S. Thyroid function abnormality and mental symptoms. Igaku no Ayumi. 1991;157:67–71. (written by Japanese)
    1. Schuff K.G., Samuels M.H., Whybrow P.C. Psychiatric and cognitive effects of hypothyroidism. In: Braverman L.E., Daniel D.S., editors. Werner and Ingbar’s the thyroid: a fundamental and clinical text. 10th ed. Lippincott-Raven Publishers; Philadelphia: 2013. pp. 596–600.
    1. Dunlap H.F., Moersch F.P. Psychiatric manifestations associated with hyperthyroidism. Am J Psychiatry. 1935;91:1215–1238.
    1. Fukao A., Takamatsu J., Miyauchi A., Hanafusa T. Endocrine diseases. iConcept Press; 2014. Stress and thyroid disease. ISBN: 978-1-922227-78-2.
    1. Mizokami T., Wu Li A., El-Kaissi S., Wall J.R. Stress and thyroid autoimmunity. Thyroid. 2004;14:1047–1055.
    1. Winsa B., Adami H.O., Bergström R., Gamstedt A., Dahlberg P.A., Adamson U. Stressful life events and Graves’ disease. Lancet. 1991;338:1475–1479.
    1. Sonino N., Girelli M.E., Boscaro M., Fallo F., Busnardo B., Fava G.A. Life events in the pathogenesis of Graves’ disease. A controlled study. Acta Endocrinol. 1993;128:293–296.
    1. Kun A.W.C. Life events, daily stresses and coping in patients with Graves’ disease. Clin Endocrinol (Oxf) 1995;42:303–308.
    1. Radosaljevic V.R., Jankovic S.M., Marinkovic J.M. Stressful life events in the pathogenesis of Graves’ disease. Eur J Endocrinol (Oxf) 1996;134:699–701.
    1. Yoshiuchi K., Kumano H., Nomura S., Yoshimura H., Ito K., Kanaji Y. Stressful life events and smoking were associated with Graves’ disease in women, but not in men. Psychosom Med. 1998;60:182–185.
    1. Matos-Santos A., Nobre E.L., Costa J.G., Nogueira P.J., Macedo A., Galvão-Teles A. Relationship between the number and impact of stressful life events and the onset of Graves’ disease and toxic nodular goiter. Clin Endocrinol (Oxf) 2001;55:15–19.
    1. Topcu C.B., Celik O., Tasan E. Effect of stressful life events on the initiation of Graves’ disease. Int J Psychiatry Clin Pract. 2012;16(4):307–311. Epub 2011 Dec 5.
    1. Gray J., Hoffenberg R. Thyrotoxicosis and stress. Quart J Med, New series. 1985;54:153–160.
    1. Chiovato L., Marino M., Perugi G. Chronic recurrent stress due to panic disorder dose not precipitate Graves’ disease. J Endocrinol Invest. 1998;21:758–764.
    1. Martin-du Pan R.C. Triggering role of stress and pregnancy in the occurrence of 98cases of Graves’ disease compared to 95cases of Hashimoto thyroiditis and 97cases of thyroid nodules. Ann Endocrinol (Paris) 1998;59:107–112.
    1. Effraimidis G., Tijssen J.G., Brosschot J.F., Wiersinga W.M. Psychoneuroendocrinology. 2012 Aug;37(8):1191–1198. Epub 2012 Jan 5.
    1. Chiovato L., Pinchera A. Stressful life events and Graves’ disease. Eur J Endocrinol. 1996;134:680–682.
    1. Ferguson-Rayport S.M. The relation of emotional factors to recurrence of thyrotoxicosis. Can Med Assoc. 1956;15:993–1000.
    1. Voth H.M., Holman P.S., Katz J.B., Wallerstein R.S. Thyroid “hot spots”: their relationship to life stress. Psychosom Med. 1970;32:561–568.
    1. Yoshiuchi K., Kumano H., Nomura S., Yoshimura H., Ito K., Kanaji Y. Psychosocial factors influencing the short term outocome of antithyroid drug therapy in Graves’ disease. Psychosom Med. 1998;60:592–596.
    1. Fukao A., Takamatsu J., Murakami Y., Sakane S., Miyauchi A., Kuma K. The relationship of psychological factors to the prognosis of hyperthyroidism in antithyroid drug-treated patients with Graves’ disease. Clin Endocrinol (Oxf) 2003;58:550–555.
    1. Vita R., Lapa D., Trimarchi F., Benvenga S. Stress triggers the onset and the recurrences of hyperthyroidism in patients with Graves’ disease. Endocrine. 2015 Feb;48(1):254–263. Epub 2014 May 23.
    1. Fukao A., Takamatsu J. The role of psychological factors on the onset and clinical course of hyperthyroid Graves’ disease. Recent Res Dev Endocrinol. 2002;3:369–376.
    1. Fukao A., Takamatsu J., Kubota S., Miyauchi A., Hanafusa T. The thyroid function of Graves’ disease patients is aggravated by depressive personality during antithyroid drug treatment. Bio Psycho Social Med. 2011;5:9.
    1. Vita R., Lapa D., Trimarchi F., Vita G., Fallahi P., Antonelli A. Certain HLA alleles are associated with stress-triggered Graves’ disease and influence its course. Endocrine. 2017 Jan;55(1):93–100. Epub 2016 Mar 7.
    1. Tiller J., Macrae A., Schmidt U., Bloom S., Treasure J. The prevalence of eating disorders in thyroid diseases: a pilot study. J Psychosom Res. 1994;18:609–616.
    1. Tanaka M., Kawai T., Kanayama Y., Kuwabara H. The miscellany of the 26th Annual Meeting of The Association of Japanese Clinical Psychology. 2007:89.
    1. Benvenga S. Benzodiazepine and remission of Graves’ disease. Thyroid. 1996;6:659–660.
    1. Vita R., Lapa D., Vita G., Trimarchi F., Benvenga S. A patient with stress-related onset and exacerbations of Graves disease. Nat Clin Pract Endocrinol Metab. 2009 Jan;5(1):55–61. Epub 2008 Nov 25.
    1. Fukao A., Takamatsu J., Tsujimoto N. Three cases of Graves’ disease patients with depression successfully treated by antidepressant (Abstr) Endocrine J. 2010;57(suppl.2)
    1. Arishima T., Fukao A. Kampo therapy for Graves’ psychosis. J Jpn Assoc Orient Psychosomatic Med. 2011;26(1):240–245. (written by Japanese with English abstract)
    1. Tanaka M., Kanayama Y., Kawai T., Kuwabara H., Kubota S., Fukao A. On the features of psychotherapy with Graves’ disease: from the experiences in a thyroid hospital. Jpn J Psychosom Int Med. 2013;17:174–179. (written in Japanese with English abstract)
    1. Fukao A. The relationship between mind and body in successful treatment by psychosomatic medicine in two female patients with Graves’ disease. J JSPOG. 2003;8:137–143. (written by Japanese with English abstract)

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit