Depression Level Among Thyroid Disorder Patients and Its Correlation
DOI:
https://doi.org/10.31436/ijcs.v4i1.145Keywords:
Thyroid disorder, Correlation, DepressionAbstract
Objective: Patients with thyroid disorders were found to experience depression due to several factors. The aims of this study was to measure depression level among thyroid disorder patients and examine the correlation between depression and Thyroid Stimulating Hormone (TSH) and free Thyroxine (fT4), stressful life events and social support level. Methods: A cross sectional study was carried out at one of the non-profit hospital at central region of Peninsular Malaysia. 153 thyroid patients were selected by using simple random sampling technique. The ethical approval was sought from IIUM Research Ethics Committee (IREC563) and the Medical Research and Ethics Committee (MREC) (NMRR-15-2127-28667). Several tools were used in this study including Depression Anxiety Stress Scale-42 (DASS-42), list of Life Threatening Experiences (LTE), Multidimensional Scale of Perceived Social Support (MSPSS); and Thyroid Function Test including TSH and fT4 were reviewed from the patient’s file. A correlation test was used to analyse the data by using SPSS version 21.0. Results: About 15% (n=23) out of 153 thyroid disorder patients had varies degree of depression (males - 7.8% (n=3) and females – 17.3% (n=20)). Also, there were positive correlation between depression and TSH (r=0.235, p=0.03), stressful life events (r=0.264, p=0.001) and negative correlation (r=-0.068, p=0.402) with perceived social support from family. Conclusion: These findings suggested that thyroid disorder patients had depression and the factors associated with depression were high TSH level, recent stressful life events and low social support from the family. These factors can be considered while assessing thyroid disorder patients who had symptoms of depression.
References
Almeida OP, Alfonso H, Flicker L, Hankey G, Chubb SP, Yeap BB. Thyroid hormones and depression: the Health in Men study. The American Journal of Geriatric Psychiatry. 2011;19(9):763-70.
Ittermann T, Völzke H, Baumeister SE, Appel K, HJ. G. Diagnosed thyroid disorders are associated with depression and anxiety. Social psychiatry and psychiatric epidemiology 2015;550(9):1417-25.
Thapa DK, Upadhyaya TL, Subedi S. The study of Psychiatric Disorders in patients with Thyroid Disorder at the tertiary care centre in Western Region of Nepal. Journal of Psychiatrists' Association of Nepal. 2013;2(2):29-34.
Aslan S, Ersoy R, Kuruoglu AC, Karakoc A, N. C. Psychiatric symptoms and diagnoses in thyroid disorders: a cross-sectional study. International journal of psychiatry in clinical practice. 2005;9(3):187-92.
Lim L. Depression: The misunderstood illness. Singapore: Armour Publishing Pte Ltd.; 2008.
Brandt F, Thvilum M, Almind D, Christensen K, Green A, Hegedüs L, et al. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study. Eur J Endocrinol. 2014;170(2):341-8.
ukao A, Takamatsu J, Kubota S, Miyauchi A, T. H. The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment. BioPsychoSocial Medicine. 2011;5(1):9.
Asagari Z, Ahmadi R, Hazarian M, Mirzapoor F. Hypo- and hyperthyroidism and associated risk factors in Northwestern Iran. The International Conference on Chemical, Environment & Biological Sciences (CEBS-2014); Kuala Lumpur, Malaysia2014.
Effraimidis G, Tijssen JG, Brosschot JF, WM. W. Involvement of stress in the pathogenesis of autoimmune thyroid disease: a prospective study. Psychoneuroendocrinology. 2012;37(8):1191-8.
Nadolnik LI. Stress and the thyroid gland. Biochemistry (Moscow) Supplement Series B: Biomedical Chemistry. 2011;5(2):103-12.
Falgarone G, Heshmati HM, Cohen R, G. R. Role of emotional stress in the pathophysiology of Graves. European Journal of Endocrinology. 2013;168:R13-8.
Roohafza HR, Afshar H, Keshteli AH, Mohammadi N, Feizi A, Taslimi M, et al. What’s the role of perceived social support and coping styles in depression and anxiety?. Journal of Research in Medical Sciences?: The Official Journal of Isfahan University of Medical Sciences. 2014;19(10):944-9.
Scannell DK. Communicating about autoimmune thyroid disease: Influences on marriage and caregiving (Doctoral dissertation). 2014. Available from: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.882.12&rep=rep1&type=pdf.
Scannell DK. Communicating about Autoimmune Thyroid Disease: Influences on Marriage and Caregiving: George Mason University; 2014.
Lim L. Depression: the misunderstood illness: Armour Publishing Pte Ltd.; 2008.
Reynolds WM, Johnston HF. Handbook of depression in children and adolescents.: Springer Science & Business Media; 2013.
Wood AM, Maltby J, Gillett R, Linley PA, Joseph S. The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality. 2008;42(4):854-71.
Easley J, Miedema B, Robinson L. It's the" good" cancer, so who cares? Perceived lack of support among young thyroid cancer survivors. In oncology nursing forum2013.
Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy. 1995;33(3):335-43.
Nieuwenhuijsen K, Verbeek JH, de Boer AG, Blonk RW, van Dijk FJ. Irrational beliefs in employees with an adjustment, a depressive, or an anxiety disorder: a prospective cohort study. Journal of Rational-Emotive & Cognitive-Behavior Therapy. 2010;28(2):57-72.
Page AC, Hooke GR, Morrison DL. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in depressed clinical samples. British Journal of Clinical Psychology. 2007;46(3):283-97.
Pinto-Gouveia J, Costa J, Marôco J. The first 2 years of rheumatoid arthritis: The influence of acceptance on pain, physical limitation and depression. Journal of Health Psychology. 2015;20(1):102-12.
Hekimoglu L, Altun ZO, Kaya EZ, Bayram N, Bilgel N. Psychometric properties of the Turkish version of the 42 item depression anxiety stress scale (DASS-42) in a clinical sample. The International Journal of Psychiatry in Medicine. 2012;44(3):183-98.
Edmed S, Sullivan K. Depression, anxiety, and stress as predictors of postconcussion-like symptoms in a non-clinical sample Psychiatry research. 2012;200(1):41-5.
Ruwaard J, Lange A, Schrieken B, Dolan CV, Emmelkamp P. The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS One. 2012;7(7).
Dahm J, Wong D, Ponsford J. Validity of the Depression Anxiety Stress Scales in assessing depression and anxiety following traumatic brain injury. Journal of affective disorders. 2013;151(1):392-6.
Bilgel N, Bayram N. Turkish Version of the Depression Anxiety Stress Scale (DASS-42): Psychometric Properties. Archives of Neuropsychiatry/Noropsikiatri Arsivi. 2010;47(2):118-26.
Akin A, Iskender M. Internet addiction and depression, anxiety and stress. International online journal of educational sciences. 2011;3(1):138-48.
Imam SS. Depression anxiety stress scales (DASS): Revisited. International Journal of Behavioral Science. 2008;3(1):104-16.
Ramli M, Rosnani S, AR AF. Psychometric profile of malaysian version of the Depressive, Anxiety and Stress Scale 42-item (DASS-42). Malaysian Journal of Psychiatry. 2012;21(1).
Ramli M, Rosnani S, Aidil AF. Psychometric profile of malaysian version of the Depressive, Anxiety and Stress Scale 42-item (DASS-42). Malaysian Journal of Psychiatry. 2012;21(1).
Brugha TS, Cragg D. The List of Threatening Experiences: The reliability and validity of a brief life events questionnaire. Acta Psychiatrica Scandinavica. 1990;82(1):77-81.
Ng CG, Amer Siddiq AN, Aida SA, Koh OH, Nor Zuraida Z. The reliability of Malay version of List of Threatening Experiences Questionnaire: A study on a group of medical students in Malaysia. Malaysian Journal of Psychiatry. 2009;18(2):46-52.
Motrico E, Moreno-Küstner B, de Dios Luna J, Torres-González F, King M, Nazareth I, ... , et al. Psychometric properties of the List of Threatening Experiences-LTE and its association with psychosocial factors and mental disorders according to different scoring methods. Journal of affective disorders. 2013;150(3):931-40.
Rosmalen JGM, Bos EH, De Jonge P. Validation of the Long-term Difficulties Inventory (LDI) and the List of Threatening Experiences (LTE) as measures of stress in epidemiological population-based cohort studies. Psychological Medicine. 2012;42(12):2599-608.
Ng CG, Amer Siddiq AN, Aida SA, Koh OH, Nor Zuraida Z. The reliability of Malay version of List of Threatening Experiences Questionnaire: A study on a group of medical students in Malaysia. Malaysian Journal of Psychiatry. 2009;18(2):46-52.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment. 1988;52(1):30-41.
Dahlem NW, Zimet GD, Walker RR. The multidimensional scale of perceived social support: a confirmation study. Journal of clinical psychology. 1991;47(6):756-61.
Tonsing K, Zimet GD, Tse S. Assessing social support among South Asians: The multidimensional scale of perceived social support. . Asian journal of psychiatry. 2012;5(2):164-8.
Vaingankar JA, Abdin E, Chong SA. Exploratory and confirmatory factor analyses of the Multidimensional Scale of Perceived Social Support in patients with schizophrenia. Comprehensive Psychiatry. 2012;53(3):286-91.
Aroian K, Templin TN, Ramaswamy V. Adaptation and psychometric evaluation of the Multidimensional Scale of Perceived Social Support for Arab immigrant women. Health care for women international. 2010;31(2):153-69.
British Thyroid Foundation. Thyroid function tests-A quick guide. 2011 [10 January 2016]; Available from: www.btf-thyroid.org.
Loh KW, Vijay Ananda P, Chan SP. A prospective study on the sociodemographic patterns and disease characteristics of patients with thyroid disease at the endocrine clinic of UMMC. The Malaysian Endocrine and Metabolic Society Annual Congress; Kuala Lumpur.2010.
Ministry of Health Malaysia. Specialty and subspecialty framework of Ministry of Health Hospitals 10MP (2010-2015). Putrajaya: Malaysia: Ministry of Health Malaysia.; 2011.
Bathla M, Singh M, Relan P. Prevalence of anxiety and depressive symptoms among patients with hypothyroidism. Indian Journal of Endocrinology and Metabolism. 2016;20(4):468-74.
Branka B, Sandra S, Dejana S, Ivan P, Aleksandar D, Katarina T, et al. Quality of life, anxiety and depression in patients with thyroid diseases and correlating factors. Acta Medica Mediterranea. 2014;30(3):731-6.
Jain L, Arora H, Verma KK, Singh H, & Aswal S. A study of correlation between depression and hypothyroidism in female patients. Delhi Psychiatry Journal. 2013;16(2):283-7.
Shinkov AD, Borisova AMI, Kovacheva RD, Vlahov YD, Dakovska LN, Atanassova ID, ..., et al. Influence of serum levels of thyroid-stimulating hormone and anti-thyroid peroxidase antibodies, age and gender on depression as measured by the Zung Self-Rating Depression Scale. Folia Medica. 2014;56(1):2-31.
Bould H, Panicker V, Kessler D, Durant C, Lewis G, Dayan C, et al. Investigation of thyroid dysfunction is more likely in patients with high psychological morbidity. Family practice. 2011;29(2):163-7.
Mandincová P. Psychosocial factors in patients with thyroid disease. InTech. 2012.
Bock C, Bukh JD, Vinberg M, Gether U, Kessing LV. Do stressful life events predict medical treatment outcome in first episode of depression?. Social Psychiatry and Psychiatric Epidemiology. 2009;44(9):752.
