Relationship of treatment outcome with thyroid hormone content in patients with biphasic disorder and depressive disorder / 中国基层医药

ABSTRACT

Objective:To explore the correlation between thyroid hormone content and treatment outcome in patients with biphasic disorder (BPD) and depressive disorder (DPD) before and after treatment.Methods:From June 2017 to June 2019, 72 patients with BPD(BPD group), 46 patients with DPD(DPD group) who met the diagnostic criteria of International Statistics and Classification of Disease and Health problems-10th Edition (ICD-10) in the Third People′s Hospital of Jiangmen, and 20 normal controls(control group) in our Hospital were enrolled in this study.The serum concentrations of total thyroxine (TT 4), total triiodothyronine (TT 3) and high sensitivity thyrotropin (HS-TSH) were measured at baseline, and the above hormone concentrations were measured in the study group after treatment for 12 weeks.The 17 Hamilton depression scale (HAMD-17) and Hamilton anxiety scale (HAMA), Bech-Rafaesdn Mania Rating Scale(BRMS) were used to evaluate the severity of symptoms at baseline and at the end of treatment.The curative effect was compared between the two groups, and the correlation between the curative effect (score reduction rate) and thyroid hormone level (concentration change) was observed. Results:At baseline, the concentrations of TT 4, TT 3 of patients with depressive phase in BPD group[(54.75±12.26)nmol/L, (86.26±15.29)nmol/L] were lower than those in the control group[(145.64±12.15)nmol/L, (156.78±36.54)nmol/L], and the TSH level in BPD group[(68.97±5.98)mIU/L]was higher than that in the control group[(45.59±9.28)mIU/L]; the levels of TT 4, TT 3 of patients with manic and mixed phase in BPD group[(166.75±12.25)nmol/L, (186.36±35.15)nmol/L] were higher than those in the control group, and the level of TSH in BPD group[(7.87±3.56)mIU/L] was lower than that in the control group; the concentrations of TT 4, TT 3 in DPD group[(65.59±23.11)nmol/L, (92.21±19.36)nmol/L] were lower than those in the control group, and the TSH level in DPD group[(69.38±14.75)mIU/L] was higher than that in the control group, the differences were ststistically significant ( t=5.867, 4.657, 2.369, 2.789, 3.247, 6.356, 4.358, 3.265, 2.365, all P<0.05). After treatment for 12 weeks, there were no statistically significant differences in TT 3, TT 4, HS-TSH concentrations among the three groups (all P>0.05). After treatment for 12 weeks, the scores of HAMa+ d, BRMS in BPD group and DPD group were significantly lower than those at baseline ( t=8.854, 12.321, 6.756, all P<0.05). The score of HAMa+ d was negatively correlated with TT 4, TT 3 concentrations, and positively correlated with HS-TSH concentration.The score of BRMS was positively correlated with TT 4, TT 3 concentrations, and negatively correlated with HS-TSH concentration. Conclusion:The level of thyroid hormone in patients with biphasic disorder and depressive disorder is different from that in normal subjects, and the level of thyroid hormone is closely related to the curative effect.