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Thyroid function and depression among adolescents: a cross-sectional study exploring sex-based differences.

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Thyroid and sex hormone levels are linked to adolescent depression, with testosterone influencing the relationship between thyroid hormone T3 and depression severity. Assessing these hormones may improve risk stratification for adolescent major depressive disorder (MDD).

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Adolescent Health

Background:

  • The interplay between thyroid hormones and sex hormones in adolescent major depressive disorder (MDD) is not well understood, particularly concerning sex-specific differences.
  • Adolescent MDD is a significant public health concern with complex underlying biological mechanisms.

Purpose of the Study:

  • To investigate the relationship between thyroid hormones, sex hormones, and MDD in adolescents.
  • To explore potential sex differences in these hormonal associations.
  • To determine if sex hormones moderate the effect of thyroid hormones on depression severity.

Main Methods:

  • Cross-sectional study of 837 adolescent outpatients with first-episode depression, stratified by severity (non-MDD vs. MDD).
  • Measurement of serum thyroid hormones (T3, FT4, FT3) and sex hormones (testosterone, estradiol, progesterone).
  • Statistical analyses included group comparisons, correlation, multivariate logistic regression, and moderation analysis.

Main Results:

  • Females had higher depression scores and lower thyroid hormone levels (T3, FT4, FT3) compared to males.
  • Depression severity correlated negatively with T4, T3, and testosterone, and positively with estradiol and progesterone.
  • A multivariate regression model including age, sex, T3, and testosterone achieved high classification accuracy (AUC=0.80).
  • Testosterone significantly moderated the T3-depression relationship, with higher T3 associated with lower depression severity in high-testosterone subgroups.

Conclusions:

  • Thyroid dysfunction is associated with adolescent MDD in a sex-specific manner.
  • Integrating thyroid and sex hormone assessments may enhance diagnostic accuracy for adolescent MDD.
  • Testosterone's moderating role suggests complex hormonal interactions influence depression severity in adolescents.