Can Sleeping Disorder Continue Despite Hypothyroidism Levothyroxine Therapy Be a Marker for Depression?

Yıl 2018, Cilt: 4 Sayı: 3, 1019 - 1027, 15.12.2018

Murat Eren Özen , Mehmet Hamdi Örüm , Ramazan İlyas Öner , Aysun Kalenderoğlu , Murad Atmaca

https://doi.org/10.30569/adiyamansaglik.470317

Cited By: 2

Öz

Aim: The aim of this study was to investigate the
frequency of depressive symptoms in patients with primary hypothyroidism, to
determine the degree of recovery of these symptoms after levothyroxine (LT4)
treatment, and to assess the presence of predictive symptoms.

Methods: 140 women with primary
hypothyroidism were evaluated with the Beck Depression Inventory (BDI). All
were treated with LT4 alone. Thyroid stimulating hormone (TSH) value was tested
after treatment and patients with previous depressive symptoms were reevaluated
with BDI.

Results: In our study, it was shown
that 72 (51.4%) patients had depressive symptoms and 68 patients (48.6%) did
not have depressive symptoms (BDI=22.8±1.1, TSH=19.1±3.7 iU/ml, (BDI=8.7±0.6,
TSH=12.0±1.2 iU/ml, age (year)=45.0±2.2). After the treatment of primary
hypothyroidism, BDI was reapplied in 72 patients with depressive symptoms (1.54
iU/ml±0.31 after TSH) in the first part of the study and depressive symptoms of
54 patients (75%) were found to be absent (BDI=9.0±1.0, TSH=1.59±0.31 iU/ml,
age (years)=45.0±2.0). Depressive symptoms persisted in 18 (25%) of the
patients (BDI=23.0±2.0, TSH=1.28±0.31 iU/ml, age (year)=42.0±2.0). Sleep
disturbance, item 16, is the only persistent persistence after treatment
(p>0.045).

Conclusion: 51.4% of hypothyroidism
patients showed depressive symptoms. Hypothyroidism therapy was sufficient to
bring the levels of TSH to normal levels in all cases and to reverse the
depressive symptom in 75% of cases. Continuation of sleep disturbance in the
remaining 25% of the group may be considered a predictive, unresponsive
symptom, and indicates that reassessment of the diagnosis and consideration of
the inclusion of another treatment should be considered.

Anahtar Kelimeler

Major depressive disorder, hypothyroidism, levothyroxine, sleep disorders

Hipotiroidizmin Levotiroksin ile Tedavisine Rağmen Devam Eden Uyku Bozukluğu Depresyon için Bir Belirteç Olabilir mi?

Öz

Amaç: Bu araştırmanın amacı, primer hipotiroidizmi olan
hastalarda depresif semptomların sıklığını araştırmak, bu semptomların
levotiroksin (LT4) tedavisi sonrası iyileşme düzeyini belirlemek ve öngörücü
semptomların varlığını değerlendirmektir.

Yöntemler: 140 primer hipotiroidizmi
olan kadın hasta Beck Depresyon Envanteri (BDÖ) ile değerlendirildi. Hepsi sadece
LT4 ile tedavi edildi. Tiroid stimüle edici hormon (TSH) değeri tedaviden sonra
test edildi ve daha önce depresif belirtiler gösteren hastalar BDÖ ile tekrar
değerlendirildi.

Bulgular: Çalışmamızda 72 (%51.4)
hastada (BDÖ=22.8±1.1, TSH=19.1±3.7 iU/ml, yaş (yıl)=44.0±2.0)
depresif belirti olduğu ve 68 hastada (%48.6) ise olmadığı gösterildi. (BDÖ=8.7±0.6,
TSH=12.0±1.2 iU/ml, yaş (yıl)=45.0± 2.2). Primer hipotiroidizmin
tedavisinden sonra, çalışmanın ilk bölümünde depresif belirtiler gösteren 72
hastada (TSH sonrası 1.54 iU/ml ±0.31) BDÖ tekrar uygulandı ve 54
hastanın (%75) depresif belirtilerinin ortadan kalktığı görüldü (BDÖ=9.0±1.0,
TSH=1.59±0.31 iU/ml, yaş (yıl)=45.0±2.0). Hastaların 18’inde
(%25) depresif semptomların devam ettiği görüldü (BDÖ=23.0±2.0, TSH=1.28±0.31
iU/ml, yaş (yıl)=42.0±2.0). Uyku bozukluğu, madde 16, tedaviden sonra
belirgin kalıcılığı olan tek faktördür (p > 0.045).

Sonuçlar: Hipotiroidizmli hastaların
%51.4'ü depresif belirtiler gösterdi. Hipotiroidizm tedavisi tüm olgularda TSH
değerlerini normal seviyesine getirmek ve %75'inde depresif belirtileri tersine
çevirmek için yeterliydi. Kalan %25’lik grupta uyku bozukluğunun devam etmesi,
öngörücü, yanıtsız bir semptom olarak düşünülebilir ve tanıyı tekrar değerlendirmek
ve başka bir tedavinin eklenmesini göz önünde bulundurmak gerektiğine işaret
eder.

Anahtar Kelimeler

Major depresif bozukluk, hipotiroidizm, levotiroksin, uyku bozuklukları

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