Post Partum Depression and Thyroid Function
-
Farahnaz Keshavarzi
,
Katayoun Yazdchi
,
Mehrali Rahimi
,
Mansour Rezaei
,
Vahid Farnia
,
Omran Davarinejad
,
Nasrin Abdoli
,
Mahmood Jalili
Abstract
Objective: Risk of depression is particularly high for women during the prenatal period. Various investigators have attempted to establish a link between thyroid function and post partum depression. This study aimed to investigate whether thyroid function differs in women with postpartum depression compared to a control group.
Methods: In this case-control study, subjects were selected from Obstetrics & Gynecology and Psychiatric clinics of Kermanshah University of Medical Sciences. Forty eight patients suffering from postpartum depression according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition totally revised (DSM-IV-TR), and 65 normal controls underwent diagnostic evaluation by one trained psychiatrist using Structured Clinical Interview for DSM-IV-TR. Then, the demographic questionnaire and the Persian version of Edinburgh Postnatal Depression Scale (EPDS) were completed by the participants. Finally, their thyroid functions were assessed. Data analyses were done using the SPSS pr gram 13.
Results: No statistically significant differences were observed between thyroid function tests and postpartum depression. According to multiple regression analysis with stepwise method, subjects with lower serum TSH, T3RU, T3 levels, younger age and longer period after delivery tended to have higher EPDS scores (P-value=0.008).
Conclusion:The present study reports that those women with postpartum depression had a no greater prevalence of thyroid dysfunction than the control subjects. It seems that thyroid dysfunction should be considered in women with postpartum depression individually, but the role of thyroid as an important cause of this condition is not yet established. This suggests that future studies should concentrate on this concept in postpartum depression.
Berga SL, Parry BL. Special Areas of Interest, Psychiatry and Reproductive Medicine. In: Sadock BJ, Sadock VA, Ruiz P, Kaplan HI, eds. Kaplan and Sadock's comprehensive textbook of psychiatry, 9th. Philadelphia: Lippincott Williams & Wilkins; 2009.
Sadock BJ, Kaplan HI, Sadock VA. Kaplan & Sadock's synopsis of psychiatry: behavioral sciences/clinical psychiatry, 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
Kendell RE, Chalmers JC, Platz C. Epidemiology of puerperal psychoses. Br J Psychiatry 1987; 150: 662-673.
Weissman MM, Olfson M. Depression in women: Implications for health care research. Science 1995;269: 799–801.
Cogill SR, Caplan HL, Alexandra H, Robson KM, Kumar R. Impact of maternal postnatal depression on cognitive development of young children. Br Med J (Clin Res Ed) 1986; 292: 1165-1167.
harp D, Hay DF, Pawlby S, Schmucker G, Allen H, Kumar R. The impact of postnatal depression on boys' intellectual development. J Child Psychol Psychiatry 1995; 36: 1315-1336.
agedahl-Strindlund M. Children of mentally ill mothers: mental development, somatic growth and social outcome. Scand J Soc Med 1988; 16: 121-127.
Harris B. Biological and hormonal aspects of postpartum depressed mood. Br J Psychiatry 1994; 164: 288-292.
Llewellyn AM, Stowe ZN and Nemeroff CB. Depression during pregnancy and the puerperium. J Clin Psychiatry 1997; 58 Suppl 15: 26-32.
Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C, et al. Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol 2002; 99: 223-228.
Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 1997; 18: 404-433.
Harris B, Fung H, Johns S, Kologlu M, Bhatti R, McGregor AM, et al. Transient post-partum thyroid dysfunction and postnatal depression. J Affect Disord 1989; 17: 243-249.
Pop VJ, de Rooy HA, Vader HL, van der Heide D, van Son M, Komproe IH, et al. Postpartum thyroid dysfunction and depression in an unselected population. N Engl J Med 1991; 324: 1815-1816.
Hendrick V, Altshuler LL, Suri R. Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics 1998; 39: 93-101.
MacCrimmon DJ, Wallace JE, Goldberg WM, Streiner DL. Emotional disturbance and cognitive deficits in hyperthyroidism. Psychosom Med 1979; 41: 331-340.
Kirkegaard C, Faber J. The role of thyroid hormones in depression. Eur J Endocrinol 1998; 138: 1-9.
Cox JL, Holden JM. Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782-786.
Montazeri A, Torkan B, Omidvari S. The Edinburgh Postnatal Depression Scale (EPDS): translation and validation study of the Iranian version. BMC Psychiatry 2007; 7: 11.
Kendell RE. Emotional, physical factors in the genesis of puerperal mental disorders. J Psychosom Res 1985; 29: 3-11.
Tamaki R, Murata M, Okano T. Risk factors for postpartum depression in Japan. Psychiatry Clin Neurosci 1997; 51: 93-98.
Posner NA, Unterman RR, Williams KN, Williams GH. Screening for postpartum depression. An antepartum questionnaire. J Reprod Med 1997; 42: 207-215.
Fava M, Labbate LA, Abraham ME and Rosenbaum JF. Hypothyroidism and hyperthyroidism in major depression revisited. J Clin Psychiatry 1995; 56: 186-192.
Joffe R, Segal Z and Singer W. Change in thyroid hormone levels following response to cognitive therapy for major depression. Am J Psychiatry 1996; 153: 411-413.
Haggerty JJ, Jr., Silva SG, Marquardt M, Mason GA, Chang HY, Evans DL, et al. Prevalence of antithyroid antibodies in mood disorders. Depress Anxiety 1997; 5: 91-96.
Pop VJ, Maartens LH, Leusink G, van Son MJ, Knottnerus AA, Ward AM, et al. Are autoimmune thyroid dysfunction and depression related? J Clin Endocrinol Metab 1998; 83: 3194-3197.
Harris B, Fung H, Johns S, Kologlu M, Bhatti R, McGregor AM, et al. Transient post-partum thyroid dysfunction and postnatal depression. J Affect Disord 1989; 17: 243-249.
Joffe RT. Antithyroid antibodies in major depression. Acta Psychiatr Scand 1987; 76: 598-599.
Harris B. Postpartum depression and thyroid antibody status. Thyroid 1999; 9: 699-703.
Pedersen CA. Postpartum mood and anxiety disorders: a guide for the nonpsychiatric clinician with an aside on thyroid associations with postpartum mood. Thyroid 1999; 9: 691-697.
Kent GN, Stuckey BG, Allen JR, Lambert T, Gee V. Postpartum thyroid dysfunction: clinical assessment and relationship to psychiatric affective morbidity. Clin Endocrinol (Oxf) 1999; 51: 429-438.
Harris B, Oretti R, Lazarus J, Parkes A, John R, Richards C, et al. Randomised trial of thyroxine to prevent postnatal depression in thyroid-antibody-positive women. Br J Psychiatry 2002; 180: 327-330.
Lucas A, Pizarro E, Granada ML, Salinas I, Sanmarti A. Postpartum thyroid dysfunction and postpartum depression: are they two linked disorders? Clin Endocrinol (Oxf) 2001; 55: 809-814.
Kuijpens JL, Vader HL, Drexhage HA, Wiersinga WM, van Son MJ, Pop VJ. Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum. Eur J Endocrinol 2001; 145: 579-584.
Pedersen CA, Johnson JL, Silva S, Bunevicius R, Meltzer-Brody S, Hamer RM, et al. Antenatal thyroid correlates of postpartum depression. Psychoneuroendocrinology 2007; 32: 235-245.
McCoy SJ, Beal JM, Payton ME, Stewart AL, DeMers AM, Watson GH. Postpartum thyroid measures and depressive symptomology: a pilot study. J Am Osteopath Assoc 2008; 108: 503-507.
| Files | ||
| Issue | Vol 6 No 3 (2011) | |
| Section | Articles | |
| Keywords | ||
| Postpartum depression Postpartum period Thyroid hormone | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
