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Randomised trial of thyroxine to prevent postnatal depression in thyroid-antibody-positive women

  • Brian Harris (a1), Rossana Oretti (a2), John Lazarus (a3), Arthur Parkes (a4), Rees John (a4), Colin Richards (a5), Robert Newcombe (a6) and Reginald Hall...

Abstract

Background

Women who are positive for thyroid antibodies in early gestation are prone to post-partum depression, apparently independent of thyroid dysfunction, as measured by serum levels of free thyroxine, free triodothyroxine and thyroid-stimulating hormone. This finding may be due to infrequent monitoring of thyroid function, because hyperthyroidism, hypothyroidism and combinations of both may occur post-partum.

Aims

To test the hypothesis that stabilising thyroid function post-partum by administering daily thyroxine reduces the rate of occurrence and severity of associated depression.

Method

In a randomised double-blind placebo-controlled trial, 100 of thyroxine or placebo was given daily to 446 thyroid-antibody-positive women (342 of whom were compliant) from 6 weeks to 6 month spost-partum, assessing their psychiatric and thyroid status at 4-weeklyintervals.

Results

There was no evidence that thyroxine had any effect on the occurrence of depression. The 6-month period prevalence of depression was similar to that reported previously.

Conclusions

The excess of depression in thyroid-antibody-positive women in the post-partum period is not corrected by daily administration of thyroxine.

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Copyright

Corresponding author

Dr Brian Harris, Consultant Psychiatrist, Department of Psychological Medicine, Bronllys Hospital, Brecon LD3 OLU, UK. Tel: +44 (0) 1874 711255; e-mall: brianharris@totalise.co.uk

Footnotes

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Declaration of interest

None. Financial support is detailed in the Acknowledgements.

Footnotes

References

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Ahmad, L., Parkes, A., Lazarus, J., et al (1998) Interleukin-6 levels are not increased in women with postpartum thyroid dysfunction. Thyroid, 8, 371375.
Amino, N., Miyal, K., Onishi, T., et al (1976) Transient hypothyroidism after delivery in autoimmune thyroiditis. Journal of Clinical Endocrinology and Metabolism, 42, 296301.
Amino, N., Mori, H., Iwatani, I., et al (1982) High prevalence of transient postpartum thyrotoxicosis and hypothyroidism. New England Journal of Medicine, 306, 849852.
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM – III – R). Washington, DC: APA.
Bluthe, R. M., Crestani, F., Kelley, K. W., et al (1992) Mechanisms of the behavioural effects of interleukin I. Annals of the New York Academy of Sciences, 650, 268275.
Cox, J. L., Holden, J. M. & Sagovsky, R. (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782786.
Fung, H. Y. M., Kologlu, M., Collison, K., et al (1988) Postpartum thyroid dysfunction in Mid Glamorgan. BMJ, 296, 241244.
Goldberg, D. (1972) The Detection of Psychiatric Illness by Questionnalre (GHQ). Maudsley Monograph no. 21. London: Oxford University Press.
Groves, C. J., Howells, R. D., Williams, S., et al (1991) Primary standardisation of the ELISA of serum thyroid peroxidase and thyroglobulin antibodies and their prevalence in a normal Welsh population. Journal of the Clinical Laboratory of Immunology, 32, 147151.
Harris, B., Fung, H., Johns, S., et al (1989) Transient postpartum thyroid dysfunction and postnatal depression. Journal of Affective Disorders, 17, 243249.
Harris, B., Othman, S., Davies, J. A., et al (1992) Association between postpartum thyroid dysfunction and thyroid antibodies and depression. BMJ, 305, 152156.
Hendrick, V., Altshuler, L. & Whybrow, P. (1998) Psychoneuroendocrinology of mood disorders: the hypothalamic-pituitary-thyroid axis. Psychiatric Clinics of North America, 21, 277292.
Kent, G. N., Stuckey, B. G. A., Allen, J. R., et al (1999) Postpartum thyroid dysfunction: clinical assessment and relationship to psychiatric affective morbidity. Clinical Endocrinology, 51, 429438.
Kuijpens, J. L., Vader, H. L., Drexhage, H. A., et al (2001) Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum. European Journal of Endocrinology, 14, 579584.
Lazarus, J. H. & Kokandi, A. (2000) Thyroid disease in relation to pregnancy: a decade of change. Clinical Endocrinology, 53, 265278.
Maes, M. (1999) Major depression and activation of the inflammatory response system. Advances in Experimental and Medical Biology, 461, 2546.
Maes, M., Libbrecht, I., Lin, A., et al (2000) Immune activation in the early puerperium is related to postpartum affective symptoms. Psychoneuroendocrinology, 25, 121137.
Maier, S. F. & Watkins, L. R. (1998) Cytokines for psychologists: implications of bi-directional immune-to-brain communication for understanding behavior, mood, and cognition. Psychological Reviews, 105, 83107.
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.
Oretti, R., Harris, B., Lazarus, J. H., et al (2002) Is there an association between life events, postnatal depression, and thyroid dysfunction in thyroid antibody women? International Journal of Social Psychiatry, in press.
Pop, V. J., de Rooy, H. J., Vader, H. L., et al (1991) Postpartum thyroid dysfunction and depression (letter). New England Journal of Medicine, 324, 18151816.
Pop, V. J., de Rooy, H. J., Vader, H. L., et al (1993) Microsomal antibodies during gestation in relation to postpartum thyroid dysfunction and depression. Acta Endocrinologica, 129, 2630.
Pop, V. J., Maartens, L. H., Leusink, G., et al (1998) Are autoimmune thyroid dysfunction and depression related? Journal of Clinical Endocrinology and Metabolism, 63, 31943197.
Prange, A. J., Wilson, I. C., Lara, P. P., et al (1972) Effects of thyrotropin releasing hormone in depression. Lancet, ii, 991002.
Prentice, J. M., Phillips, D. I., Sarsero, D., et al (1990) Geographical distribution of sub-clinical auto immune thyroid disease in Britaln. A study using highly sensitive direct assays for autoantibodies to thyroglobulin and thyroid peroxidase. Acta Endocrinologica, 123, 493498.
Reichenberg, A., Yirmiya, R., Schuld, A., et al (2001) Cytokine-associated emotional and cognitive disturbances in humans. Archives of General Psychiatry, 58, 445452.
Roberton, H. E. W. (1948) Lassitude, coldness and hair changes following pregnancy, and their treatment with thyroid extract. BMJ, ii (suppl), 22752276.
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria; rationale and reliability. Archives of General Psychiatry, 36, 773782.

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Randomised trial of thyroxine to prevent postnatal depression in thyroid-antibody-positive women

  • Brian Harris (a1), Rossana Oretti (a2), John Lazarus (a3), Arthur Parkes (a4), Rees John (a4), Colin Richards (a5), Robert Newcombe (a6) and Reginald Hall...
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