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An "increase-decrease-increase" pattern: TSH levels and anxiety symptoms in treatment-naïve first-episode patients

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Summary
This summary is machine-generated.

Thyroid-stimulating hormone (TSH) levels show a nonlinear link with anxiety in major depressive disorder (MDD). Higher or lower TSH concentrations correlate with increased anxiety in treatment-naïve, first-episode MDD patients.

Keywords:
AnxietyFirst-episodeInflection pointMajor depressive disorderThyroid-stimulating hormone

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Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Clinical Medicine

Background:

  • The relationship between thyroid-stimulating hormone (TSH) and anxiety symptoms in major depressive disorder (MDD) is not well-established.
  • Previous research has yielded inconclusive findings regarding this association.

Purpose of the Study:

  • To investigate the association between TSH concentrations and anxiety symptoms in treatment-naïve, first-episode (TNFE) MDD patients.
  • To explore potential nonlinear relationships and identify inflection points.

Main Methods:

  • Utilized multivariate logistic regression to analyze TSH concentrations and anxiety symptoms in 1718 TNFE MDD patients.
  • Employed piecewise logistic regression and smoothing plots to examine nonlinearity and identify inflection points.
  • Conducted subgroup analyses to assess potential effect modifiers.

Main Results:

  • A positive correlation was found between TSH concentrations and anxiety symptoms in TNFE MDD patients (adjusted OR=1.31).
  • Nonlinear relationships were observed, with inflection points at 4.30 and 6.90 μIU/mL.
  • TSH levels <4.30 μIU/mL and ≥6.90 μIU/mL were positively associated with anxiety, while levels between 4.30-6.90 μIU/mL showed a negative association.

Conclusions:

  • A significant nonlinear association exists between TSH concentrations and anxiety symptoms in TNFE MDD patients.
  • TSH assessment may aid in understanding anxiety symptoms within the context of MDD.
  • No significant effect modification was found for sex, marital status, suicide, or psychotic symptoms.