Níveis de TSH e sintomas depressivos em mulheres acima de 35 anos do Município do Rio de Janeiro

Abstract

Some studies have been indicating that hypothyroidism is a risk factor for depression; however, this association is still controversial. The present study estimated the prevalence of depressive symptoms in a probabilistic sample of women and investigated whether there was any association between thyroid-stimulating hormone (TSH) levels and the presence of depressive symptoms. A cross-sectional population-based study was carried out and sample of women aged 35 years and over living in the municipality of Rio de Janeiro (RJ) was evaluated. They were interviewed and blood samples were taken. The sample design proposed for this study followed a model of probabilistic sampling by clusters, with three selection stages based on the census tracts of municipality. Thyroid functions was measured from serum TSH levels, using samples collected in the subjects homes. To assess the presence/absence of depressive symptoms, a standardized validated instrument (PRIME-MD) was used. Sociodemographic data and other information on participants health were also gathered. The prevalence of depressive symptoms, frequencies and associations were calculated while taking into account the design of this complex sample, using specific procedures from the SAS statistical package (version 9.1). Out of a sample of 1500 women, 1298 were interviewed. The no-response rate was 13.5%. The final sample was composed of 1249 participants, among whom a prevalence of depressive symptoms of 45.9% was found. Regarding TSH levels, 4.8% of the sample was above the cutoff point adopted (&#8805;6.0 mUl/ml). Of these, 61.9% presented depressive symptoms, versus 44.9% among the women with TSH <6.0 (p=0.04). The adjusted analysis showed that the women with TSH levels &#8805; 6.0 had twice as much chance of presenting depressive symptoms as did those with normal TSH levels (OR= 2.04). when the participants who self-reported a previous diagnosis of thyroid disease were excluded from the analysis, the association between TSH levels and depressive symptoms lost its significance. High prevalence of depressive symptoms was observed in the sample, specially among the group with high TSH levels. The results draw attention towards the importance of investigating thyroid comorbidity in depressed patients.