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Association of Thyroid Function With Depression: A Historical Cohort Study.

Junting Liu1, Brooke Ellen Delgoffe2, Rachel Gabor2

  • 1Department of Internal Medicine, Marshfield Clinic Health System, Marshfield, WI.

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Both low and very high thyroid-stimulating hormone (TSH) levels are linked to increased odds of depression. This association was observed across various patient groups, highlighting a complex relationship between thyroid function and mental health.

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Epidemiology

Background:

  • Inconsistent evidence exists regarding the association between thyroid dysfunction and depression.
  • Thyroid-stimulating hormone (TSH) is a key indicator of thyroid function.
  • Depression is a prevalent mental health condition with significant public health implications.

Purpose of the Study:

  • To investigate the relationship between thyroid-stimulating hormone (TSH) levels and depression.
  • To determine if TSH levels are associated with clinically relevant depression using the Patient Health Questionnaire-9 (PHQ-9).

Main Methods:

  • A population-based study including 31,099 adult patients from the Marshfield Clinic Health System (2015-2020).
  • Patients with completed TSH levels and PHQ-9 scores within a 2-week period were included.
  • Logistic regression analysis adjusted for covariates was used to assess the association between TSH levels and depression (PHQ-9 score ≥10).

Main Results:

  • Patients with clinically relevant depression exhibited higher TSH levels compared to those without depression (P=0.01).
  • Both low TSH (<0.5 mIU/L) and very elevated TSH (≥10 mIU/L) levels were associated with increased odds of depression (OR 1.30 and 1.50, respectively).
  • Similar associations were found in subgroups including patients with mood disorders, females, younger adults, and those with untreated thyroid disorders.

Conclusions:

  • Low and very elevated TSH levels are associated with higher odds of depression in a large cross-sectional study.
  • These associations were consistent across several subgroups, suggesting a broad impact of thyroid function on depression risk.
  • Further large prospective studies are warranted to elucidate the causal relationship between TSH levels and clinical depression.