COMPARISON OF SELF ESTEEM, ANXIETY AND DEPRESSION WITH CORTISOL/DEHYDROEPIANDROSTERONE SULFATE RATIOS IN HYPOTHYROID

Yıl 2025, Cilt: 26 Sayı: 1, 56 - 60, 27.01.2025

Hafize Kızılkaya , Elif Turan , Gurbet Bozkurt , Yeşim Göçmen , Yalcin Aral

https://doi.org/10.18229/kocatepetip.1335749

Öz

OBJECTIVE: We aim to investigate the relationship self esteem, anxiety and depression with cortisol/dehydroepiandrosterone sulfate (DHEAS) ratios in hypothyroid patients.
MATERIAL AND METHODS: Total of 150 subjects, aged between 18-70 years were included study. Patients were divided into three groups as euthyroid, subclinical hypothyroid and hypothyroid. Fasting blood was drawn to obtain thyroid function, DHEAS and cortisol levels. Each patients filled the Beck Depression Scale, Beck Anxiety Scale and Rosenberg Self-Esteem Scale with the same psychologist.
RESULTS: Cortisol, cortisol/DHEAS ratios, depression and anxiety scores were significantly higher in hypothyroid group. A negative correlation was found between cortisol levels and self-esteem scores (r=-.233, p<.05); TSH levels and anxiety (r=-0.212, p<.05); self respect and anxiety (r=-0.297, p<.05); depression and self respect (r=-0.411, p<.05); depression and cortisol/DHEAS ratio (r=-0.187, p<.05). A positive correlation was found between cortisol and anxiety (r=+0.195, p<.05); cortisol and cortisol/DHEAS ratio (r=+0.533, p<.05), free T3 and self esteem score (r=-.202, p<.05).
CONCLUSIONS: Patients with overt hypothyroidism were associated with low self-esteem, anxiety and depression scores. In addition, a negative correlation was found between depression scores and cortisol/DHEAS ratio.

Anahtar Kelimeler

Hypothyroidism, Cortisol, Self-esteem, Anxiety, Depression.

Destekleyen Kurum

Bozok Üniversitesi Tıp Fakültesi, Proje Koordinasyon Uygulama ve Araştırma Merkezi tarafından desteklenmiştir.

Proje Numarası

6601‑TF/16‑34

Teşekkür

none

HİPOTİROİDİDE, BENLİK SAYGISI, ANKSİYETE VE DEPRESYON İLE KOTİZOL/DEHİDROEPİANDROSTERON SULFAT ORANLARININ KARŞILAŞTIRILMASI

Öz

AMAÇ: Hipotiroidisi olan hastalarda benlik saygısı, anksiyete ve depresyon ile kortizol/dehidroepiandrosteron sülfat (DHEAS) oranları arasındaki ilişkiyi araştırmayı amaçladık.
GEREÇ VE YÖNTEM: : Çalışmaya 18-70 yaş arası toplam 150 kişi dahil edildi. Hastalar ötiroid, subklinik hipotiroid ve hipotiroid olarak üç gruba ayrıldılar. Tiroid fonksiyonu, DHEAS ve kortizol düzeylerini elde etmek için açlık kanı alındı. Her hasta aynı psikolog tarafından Beck Depresyon Ölçeği, Beck Anksiyete Ölçeği ve Rosenberg Benlik Saygısı Ölçeği'ni doldurdu.
BULGULAR: Kortizol, kortizol/DHEAS oranları, depresyon ve anksiyete puanları hipotiroidi grubunda anlamlı olarak yüksekti. Kortizol düzeyleri ile benlik saygısı puanları arasında (r=-.233, p<.05); TSH düzeyleri ve kaygı (r=-0.212, p<.05) arasında; kendine saygı ve kaygı (r=-0.297, p<.05) arasında; depresyon puanları ve kendine saygı (r=-0.411, p<.05) arasında; depresyon puanları ve kortizol/DHEAS oranı (r=-0.187, p<.05) arasında negatif korelasyon bulundu. Kortizol ile anksiyete puanları arasında (r=+0.195, p<.05); kortizol ve kortizol/DHEAS oranı (r=+0.533, p<.05) arasında ve de serbest T3 ve benlik saygısı puanı (r=+.202, p<.05) arasında ise pozitif kolerasyon bulundu.
SONUÇ: Belirgin hipotiroidisi olan hastalar düşük benlik saygısı, anksiyete ve depresyon puanları ile ilişkiliydi. Ayrıca depresyon puanları ile kortizol/DHEAS oranıyla negatif korelasyon bulundu.

Anahtar Kelimeler

hipotiroidi, kortizol, DHEAS, Benlik saygısı

Proje Numarası

6601‑TF/16‑34

Kaynakça

• 1. Duval F. Endocrinologie et psychiatrie. Encycl Méd Chir (Elsevier, Paris). 2003:37-640.
• 2. Fischer S, Ehlert U. Hypothalamic–pituitary–thyroid (HPT) axis functioning in anxiety disorders. A systematic review. Depression and Anxiety. 2018;35(1):98-110.
• 3. Jackson I, Luo L-G. Antidepressants inhibit the glucocorticoid stimulation of thyrotropin releasing hormone expression in cultured hypothalamic neurons. Journal of Investigative Medicine: The Official Publication of the American Federation for Clinical Research. 1998;46(9):470-4.
• 4. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, et al. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670-751.
• 5. Nguyen DT, Wright EP, Dedding C, et al. Low self-esteem and its association with anxiety, depression, and suicidal ideation in vietnamese secondary school students: a cross-sectional study. Frontiers in psychiatry. 2019;27(10):698.
• 6. Gillespie CF, Nemeroff CB. Hypercortisolemia and depression. Psychosomatic medicine. 2005;67:26-8.
• 7. Musselman DL, Nemeroff CB. Depression and endocrine disorders: focus on the thyroid and adrenal system. The British Journal of Psychiatry. 1996;168(30):123-28.
• 8. Scott LV, Svec F, Dinan T. A preliminary study of dehydroepiandrosterone response to low-dose ACTH in chronic fatigue syndrome and in healthy subjects. Psychiatry Research. 2000;97(1):21-8.
• 9. Hechter O, Grossman A, Chatterton Jr R. Relationship of dehydroepiandrosterone and cortisol in disease. Medical Hypotheses. 1997;49(1):85-91.
• 10. Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J Psychol. 1989;7:3-13.
• 11. Avcı MG. Beck Anksiyete Ölçeği'nin geçerlik ve güvenirlik çalışması: Ege Üniversitesi; 1995.
• 12. Rosenberg M. Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy Measures Package. 1965;61(52):18.
• 13. Gunes NA. Evaluation of anxiety and depression in patients with thyroid function disorder. Revista da Associação Médica Brasileira. 2020;66:979-85.
• 14. Saxena J, Singh P, Srivastava U, Siddiqui A. A study of thyroid hormones (T3, T4 & TSH) in patients of depression. Indian Journal of Psychiatry. 2000;42(3):243.
• 15. Placidi G, Boldrini M, Patronelli A, et al. Prevalence of psychiatric disorders in thyroid diseased patients. Neuropsychobiology. 1998;38(4):222-25.
• 16. Gupta S, Saha PK, Mukhopadhyay A. Prevalence of hypothyroidism and importance of cholesterol estimation in patients suffering from major depressive disorder. Journal of the Indian Medical Association. 2008;106(4):240-42.
• 17. Forman‐Hoffman V, Philibert R. Lower TSH and higher T4 levels are associated with current depressive syndrome in young adults. Acta Psychiatrica Scandinavica. 2006;114(2):132-39.
• 18. Gulseren S, Gulseren L, Hekimsoy Z, et al. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Archives of Medical Research. 2006;37(1):133-39.
• 19. Smith CD, Grondin R, LeMaster W, et al. Reversible cognitive, motor, and driving impairments in severe hypothyroidism. Thyroid. 2015;25(1):28-36.
• 20. Abdulateef DS, Mahwi TO. Assessment of hair cortisol in euthyroid, hypothyroid, and subclinical hypothyroid subjects. Endocrine. 2019;63(1):131-39.
• 21. Ndoye O, Mbodj M, Akala A, et al. Serum cortisol level variations in thyroid diseases. Dakar Medical. 2000;45(1):30-3.
• 22. Tagawa N, Tamanaka J, Fujinami A, et al. Serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, and pregnenolone sulfate concentrations in patients with hyperthyroidism and hypothyroidism. Clinical Chemistry. 2000;46(4):523-28.
• 23. Shields GS, Moons WG, Slavich GM. Better executive function under stress mitigates the effects of recent life stress exposure on health in young adults. Stress. 2017;20(1):92-102.
• 24. Prall SP, Larson EE, Muehlenbein MP. The role of dehydroepiandrosterone on functional innate immune responses to acute stress. Stress and Health. 2017;33(5):656-64.
• 25. Maninger N, Wolkowitz OM, Reus VI, et al. Neurobiological and neuropsychiatric effects of dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS). Frontiers in Neuroendocrinology. 2009;30(1):65-91.
• 26. Feder A, Nestler E, Charney D. Psychobiologie a molekulární genetika odolnosti. Nat Rev Neurosci. 2009;10:446-57.
• 27. Fiksdal A, Hanlin L, Kuras Y, et al. Associations between symptoms of depression and anxiety and cortisol responses to and recovery from acute stress. Psychoneuroendocrinology. 2019;102:44-52