Korean J Health Promot.  2018 Mar;18(1):32-41. 10.15384/kjhp.2018.18.1.32.

Depression in Patients with Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

• Hwang E
• Shin S

• KMID: 2409070
• DOI: http://doi.org/10.15384/kjhp.2018.18.1.32

Abstract

BACKGROUND
Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression.
METHODS
This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064.
RESULTS
Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20-0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression.
CONCLUSIONS
This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.

Keyword

Hypothyroidism; Depression; Meta-analysis

MeSH Terms

Aged
Atherosclerosis
Depression*
Female
Humans
Hypothyroidism*
Mass Screening
Memory Disorders
Search Engine

Figure

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  Figure 1 Flow chart of study selection. Abbreviation: RCT, randomized contolled trial.

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  Figure 2 Effect size of depression among subclinical hypothyroidism. Heterogeneity: I-squared=90.02%, tau-squared=0.180, P=0.000 Abbreviations: Std diff, standard difference; CI, confidence interval.

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  Figure 3 Effect size of depression according to the gender. Heterogeneity: I-squared=92.16%, tau-squared=0.039, P=0.000 Abbreviations: Std diff, standard difference; CI, confidence interval.

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  Figure 4 Effect size of depression acdording to the sample size. Heterogeneity: I-squared=92.16%, tau-squared=0.039, P=0.000 Abbreviations: Std diff, standard difference; CI, confidence interval.

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  Figure 5 Effect size of depression according to the data adjustment. Heterogeneity: I-squared=92.16%, tau-squared=0.039, P=0.000 Abbreviations: Std diff, standard difference; CI, confidence interval.

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  Figure 6 Publication bias. Abbreviations: Std, standardized; diff, difference.

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