Thyroid Function Within the Normal Range and the Risk of Depression: A Population-Based Cohort Study
Abstract
Context: Overt hypo- and hyperthyroidism are associated with an increased risk of depression. Little is known about the effects of variation in thyroid function within the normal range on the risk of depression. Objective: The objective of the study was to examine the association between normal-range thyroid function and the risk of depression. Design, Setting, and Participants: This was a cohort study in 1503 Dutch men and women, aged 70.6 (7.3) (mean [SD]) years. At baseline, serum TSH, thyroperoxidase antibody levels, and depressive symptoms [Center for Epidemiologic Studies Depression Scale (CES-D)] were assessed. A CES-D of 16 or greater is indicative of a depressive disorder. During follow-up (mean 8.0 y), participants were continuously monitored for the occurrence of incident depressive syndromes (n = 156). Results: Cross-sectionally, persons in the lowest TSH tertile (0.3–1.0 mU/L) had more depressive symptoms [CES-D score (mean): 7.95 vs 6.63, P = .014] as well as an increased risk of a CES-D of 16 or greater [10.7% vs 5.0%, odds ratio (95% confidence interval) 2.22 (1.18–4.17)], compared with persons in the highest normal range TSH tertile (1.6–4.0 mU/L). In the prospective analyses, persons in the lowest TSH tertile who were depression free at baseline had a higher risk of incident depressive syndromes [12.3% vs 7.6%, odds ratio (95% confidence interval) 1.85 (1.10–3.11)]. Thyroid autoimmunity (thyroperoxidase antibody positivity) was not associated with CES-D scores or incident depressive syndromes. Conclusions: Elderly persons with low-normal TSH levels have more concurrent depressive symptoms as well as a substantially increased risk of developing a depressive syndrome in the subsequent years. This study identifies low-normal TSH as an important risk factor for depression in the elderly.
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Elderly persons with the lowest TSH tertile at baseline had more concurrent depressive symptoms and were at two-fold increased risk of subsequent depression than those with the highest tertile.
“In addition, elderly persons with the lowest TSH tertile at baseline had more concurrent depressive symptoms and were at two-fold increased risk of subsequent depression than those with the highest tertile [108].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [108]
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- Authors
- Medici, M., Direk, N., Visser, W. E., Korevaar, T. I. M., Hofman, A., Visser, T. J., Tiemeier, H., & Peeters, R. P.
- Affiliations
- Erasmus MC (NL)
- Epidemiology (N.D., A.H., H.T.), Erasmus Medical Center, 3000 CA, Rotterdam, The Netherlands
- Departments of Internal Medicine (M.M., W.E.V., T.I.M.K., T.J.V., R.P.P.), Rotterdam, The Netherlands
- Corresponding author
- Peeters, Robin P.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-04-01
- Volume
- 99
- Issue
- 4
- Pages
- 1213-1219
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2102954259
- Cited by
- 123
- References
- 44
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 12 · 2023: 11 · 2022: 9 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 8 · 2017: 4 · 2016: 9 · 2015: 14 · 2014: 1
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- depression, thyroid function, thyroid-stimulating hormone, older adults, depressive symptoms, thyroid peroxidase antibodies, thyroid autoimmunity, incident depression, risk factors for depression
- MeSH terms
- Aged, Cross-Sectional Studies, Depressive Disorder, Female, Humans, Male, Middle Aged, Netherlands, Reference Values, Risk Factors, Thyroid Function Tests, Thyroid Gland, Cohort Studies, Incidence
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