Published: 2017-02-20

Thyroid profile in depression: a cross-sectional study from North-East India

Jyoti Hazarika, Kamal N. Kalita, Mohan Sharma, Shilpi Saikia, Priyanka Patangia, Pranabjyoti Hazarika, Anil C. Sarmah


Background: Thyroid function disorder is a common feature in depression, with mixed type of response. Some cases are associated with hyperthyroidism and most commonly hypothyroidism. Unipolar and bipolar depressions are also related differently in consideration to thyroid status. This study comprises of assessment of the thyroid disorder prevalence in depressive patients and comparative analysis among unipolar and bipolar groups.

Methods: Study consisted of 161 unipolar and 160 bipolar cases of depression as diagnosed by ICD 10 criteria supported by MINI. Thyroid profiling was done against common thyroid hormones TSH, T3, T4 and FT4 by standard method.

Results: Gender wise males were dominant with majority in bipolar group in the younger age group. Most of the cases were normal with few hyperthyroid and hypothyroid cases. Bipolar group comprised the majority of overt hyperthyroid, overt hypothyroid and subclinical hyperthyroid cases, whereas unipolars were more in the subclinical hypothyroid category.

Conclusions: This study concludes that differences exist in the thyroid response among the unipolar and bipolar depression group, more prominent numbers of hypothyroidism in unipolar group.


Bipolar, Depression, North-East India, Thyroid dysfunction, Unipolar

Full Text:



World Health Organization, DEPRESSION A Global Public Health Concern, 2012. Available at: management/ depression/ whopaper_ depression_ wfmh_20 12.pdf. Accessed 22 February 2016.

Doris A, Ebmeier K, Shajahan P. Depressive illness. Lancet. 1999;354:1369-75.

World Health Organization, The global burden of disease: 2004 update [Internet]. Geneva, Switzerland, World Health Organization; 2008. Available at: healthinfo/ global_burden_disease/GBD_report_2004update_full.pdf?ua=1. Accessed 02 April 2016.

Hirschfeld RM, Vornik LA. Bipolar disorder--costs and comorbidity. Am J Manag Care. 2005;11:S85-90.

Goodwin FK, Jamison KR. Manic-depressive illness: bipolar disorders and recurrent depression. New York, N.Y: Oxford University Press. 2007.

Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatr. 2003;64:161-74.

Larsen PR, Silva JE, Kaplan MM. Relationships between circulating and intracellular thyroid hormones: physiological and clinical implications. Endocr Rev. 1981;2:87-102.

Hage MP, Azar ST. The Link between Thyroid Function and Depression. J Thyroid Res. 2012;2012: Article ID 590648.

Wolkowitz OM, Rothschild AJ. Psychoneuroendocrinology: The Scientific Basis of Clinical Practice, American Psychiatric, Washington, DC, USA, 1st edition. 2003.

Feldman AZ, Shrestha RT, Hennessey JV. Neuropsychiatric manifestations of thyroid disease. Endocrinol Metab Clin North Am. 2013;42:453-76.

Rybakowski J, SowiƄski J. Free-thyroxine index and absolute free-thyroxine in affective disorders. Lancet. 1973;7808:889.

Valle J, Ayuso-Gutierrez JL, Abril A, Ayuso-Mateos JL. Evaluation of thyroid function in lithium-naive bipolar patients. Eur Psychiatr. 1999;14:341-5.

Ezzaher A, Haj Mouhamed D, Mechri A, Neffati F, Douki W, Gaha L. Thyroid function and lipid profile in bipolar I patients. Asian J Psychiatr. 2011;4:139-43.

Bunevicius R, Pranje AJ Jr. Thyroid Disease and Mental Disorders: Cause and Effect or only Comorbidity? Curr Opin Psychiatr. 2010;23:363-8.

Marian G, Nica EA, Ionescu BE, Ghinea D. Hyperthyroidism- cause of depression and psychosis: a case report. J Medicin and Life. 2009;2:440-2.

Loosen PT. The TRH-induced TSH response in psychiatric patients: a possible neuroendocrine marker. Psychoneuroendocrinology. 1985;10:237-60.

Linkowski P, Brauman H, Mendlewicz J. Thyrotrophin response to thyrotrophin-releasing hormone in unipolar and bipolar affective illness. J Affect Disord. 1981;3:9-16.

Nisha A, Sathesh V, Punnoose VP, Varghese PJ. A comparative study on psycho-socio- demographic and clinical profile of patients with bipolar versus unipolar depression. Indian J Psychiatry. 2015;57:392-6.

Venkoba Rao A, Madhavan T. Depression and suicide behaviour in the aged. Indian J Psychiatry. 1983; 25: 251-9.

Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of Depression in a Large Urban South Indian Population- The Chennai Urban Rural Epidemiology Study (Cures-70). PLoS ONE 2009;4(9):e7185.

Van de Velde S, Bracke P, Levecque K. Gender difference in depression in 23 European countries. Cross-national variation in the gender gap in depression. Soc Sci Med. 2010;71:305-13.

Verma RK, Min TH, Chakravarthy S, Barua A, Kar K. Sociodemographic Correlates of Unipolar Major Depression among the Chinese Elderly in Klang Valley, Malaysia: An Epidemiological Study. The Scientific World Journal 2014; Article ID 812712:1-9.

Sham SYZ, Umar NA, Hambali Z, Razali R, Manaf MRA. Subclinical hypothyroidism among patients with depressive disorders. Malay J of Med and Health Sciences. 2014;10:71-8.

Chueire VB, Romaldini JH, Ward LS. Subclinical hypothyroidism increases the risk for depression in the elderly. Arch Gerontol Geriatr. 2007;44:21-8.

Ozerdem A, Tunca Z, Cimrin D, Hidiroglu C, Ergor G. Female vulnerability for thyroid function abnormality in bipolar disorder: role of lithium treatment. Bipolar Disord. 2014;16:72-82.

Wysokinski A, Kloszewska. Level of Thyroid-Stimulating Hormone (TSH) in Partients with Acute Schizophrenia, Unipolar Depression or Bipolar Disorder. Neurochem Res. 2014;39:1245-53.