[Thyroid autoantibodies in depressive disorders]

Whereas clinical relevant hypo- as well as hyperthyreosis are strongly suspected to induce psychiatric symptoms, there is a controversy about the relevance of only subclinical and autoimmune findings. We found autoantibodies (MAK, TAK, TRAK) in a high percentage (100 out of 144 = 70%) in severely depressed inpatients. Also we found a Hashimoto thyreoiditis in 5 patients. In the long run this may lead to relevant hypothyreosis which is regarded to be a risk factor for depression and for possible non-response in medical treatment. We conclude that in cases of repeated depressive episodes especially depression of the elderly and in nonresponders it seems necessary not only to get lab for TSH, T3 and T4 but also to assess the autoimmune status of the thyroid gland (autoantibodies). There is further need for controlled studies whether there is a better outcome in nonresponders to antidepressive medical treatment and positive autoantibody status after supplementation with triiodothyronine.