Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

I wonder if even a single person here will be surprised by the conclusion? Nonetheless, it is so very important that we see such studies performed and published. And thanks to PubMed and TUK/HU, they get brought to the attention of us - the thyroid patients.

Thyroid. 2014 Jan 2. [Epub ahead of print]

Increased psychiatric morbidity before and after the diagnosis of hypothyroidism: A nationwide register study.

Thvilum M, Brandt F, Almind D, Christensen K, Brix TH, Hegedus L.

Author information

Odense University Hospital, Department of Endocrinology and Metabolism, Odense C, Denmark ;


Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity.

Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively.

Results: Prior to the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (Odds ratio, OR, 1.51; 95% confidence interval (CI): 1.12-2.04) and increased prevalence of treatment with antipsychotics (OR 1.49; 95% CI: 1.29-1.73), antidepressants (OR 1.50; 95% CI: 1.35-1.67), and anxiolytics (OR 1.28; 95% CI: 1.16-1.41). After the diagnosis of hypothyroidism, patients had a higher risk of being diagnosed with a psychiatric disorder (Hazard ratio, HR, 2.40; 95% CI: 1.81-3.18), and an increased risk of being treated with antidepressants (HR 1.30; 95% CI: 1.15-1.47) and anxiolytics (HR 1.27; 95% CI: 1.10-1.47), but not antipsychotics (HR 1.13; 95% CI: 0.91-1.41). Based on the twin data, we could not demonstrate genetic confounding.

Conclusions: Subjects with hypothyroidism have an increased risk of being diagnosed with a psychiatric disorder as well as being treated with antidepressants, antipsychotics and anxiolytics both before and after the diagnosis of hypothyroidism.

PMID: 24383722 [PubMed - as supplied by publisher]


Image is of the hospital where the people who performed the study work.

4 Replies

  • Thanks Rod for this - another good article.

  • Very interesting, thank you for posting. No I'm not surprised - but I am shocked.

    I'd like to know more about what happened after diagnosis of hypothyroidism. How were they treated? T4 only?

    I wonder if the increase after diagnosis applies to all who are hypothyroid or to those who are not treated with regard to 'optimal'.

    Do those who respond well to treatment and achieve 'optimal' revert back to the levels expected for people without hypothyroidism?

    So many questions!

    If increased psychiatric morbidity remained high in those who are optimally treated for hypothyroidism, then I'd be surprised.


  • No surprise considering most of us are not treated been medically medicated! As in under medicated!

  • A close relative has just been diagnosed with a mental illness. I am shocked and frustrated at the medical profession's lack of investigation into what I'm sure is a link between years on a vegan diet, ME, Hashimoto's, poor absorption of minerals, and, more recently, a huge number of symptoms relating to a severe B12 deficiency.

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