Low yield of thyroid-stimulating hormone testing in elderly patients with depression

Shelagh A. Fraser, Kurt Kroenke, Christopher Callahan, Siu Hui, John W. Williams, Jürgen Unützer

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Although hypothyroidism is purportedly an important cause of depression, prior studies have involved small samples of young people and produced conflicting results. We examined the yield of thyroid-stimulating hormone (TSH) testing in a large group of elderly patients with major depression or dysthymic disorder. The study sample comprised 883 outpatients aged 60 years or older from 18 primary care sites enrolled in the intervention arm of a clinical trial of depression management. Thyroid function was assessed by a single TSH value. Depressive diagnoses were confirmed with the Structured Clinical Interview for DSM-IV (SCID) and depression severity was assessed with the HSCL-20, a modified depression scale of the Hopkins Symptom Checklist. TSH results were available for 725 (82.1%) participants. Although 32 (4.4%) of those tested had TSH>5 mIU/L, the vast majority (27/32) had marginally elevated results (5.1-9.4 mIU/L). Only five patients (0.7%) had TSH levels >10 mIU/L. Patients with elevated TSH did not differ from those with TSH≤5 mIU/L in the severity or symptom pattern of depression as measured by the baseline HSCL-20 score (P=.37) or SCID score (P=.44). These findings should caution physicians against acceptance of borderline TSH values as the primary cause of a patient's clinical depression.

Original languageEnglish
Pages (from-to)302-309
Number of pages8
JournalGeneral Hospital Psychiatry
Volume26
Issue number4
DOIs
StatePublished - Jul 2004

Fingerprint

Thyrotropin
Depression
Diagnostic and Statistical Manual of Mental Disorders
Dysthymic Disorder
Interviews
Hypothyroidism
Checklist
Primary Health Care
Thyroid Gland
Outpatients
Clinical Trials
Physicians

Keywords

  • Depression
  • Hypothyroidism
  • Primary healthcare
  • Thyroid-stimulating hormone

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)
  • Psychiatry and Mental health

Cite this

Low yield of thyroid-stimulating hormone testing in elderly patients with depression. / Fraser, Shelagh A.; Kroenke, Kurt; Callahan, Christopher; Hui, Siu; Williams, John W.; Unützer, Jürgen.

In: General Hospital Psychiatry, Vol. 26, No. 4, 07.2004, p. 302-309.

Research output: Contribution to journalArticle

@article{6fddfcb175f64bf6b64daa308c42f31a,
title = "Low yield of thyroid-stimulating hormone testing in elderly patients with depression",
abstract = "Although hypothyroidism is purportedly an important cause of depression, prior studies have involved small samples of young people and produced conflicting results. We examined the yield of thyroid-stimulating hormone (TSH) testing in a large group of elderly patients with major depression or dysthymic disorder. The study sample comprised 883 outpatients aged 60 years or older from 18 primary care sites enrolled in the intervention arm of a clinical trial of depression management. Thyroid function was assessed by a single TSH value. Depressive diagnoses were confirmed with the Structured Clinical Interview for DSM-IV (SCID) and depression severity was assessed with the HSCL-20, a modified depression scale of the Hopkins Symptom Checklist. TSH results were available for 725 (82.1{\%}) participants. Although 32 (4.4{\%}) of those tested had TSH>5 mIU/L, the vast majority (27/32) had marginally elevated results (5.1-9.4 mIU/L). Only five patients (0.7{\%}) had TSH levels >10 mIU/L. Patients with elevated TSH did not differ from those with TSH≤5 mIU/L in the severity or symptom pattern of depression as measured by the baseline HSCL-20 score (P=.37) or SCID score (P=.44). These findings should caution physicians against acceptance of borderline TSH values as the primary cause of a patient's clinical depression.",
keywords = "Depression, Hypothyroidism, Primary healthcare, Thyroid-stimulating hormone",
author = "Fraser, {Shelagh A.} and Kurt Kroenke and Christopher Callahan and Siu Hui and Williams, {John W.} and J{\"u}rgen Un{\"u}tzer",
year = "2004",
month = "7",
doi = "10.1016/j.genhosppsych.2004.03.007",
language = "English",
volume = "26",
pages = "302--309",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Low yield of thyroid-stimulating hormone testing in elderly patients with depression

AU - Fraser, Shelagh A.

AU - Kroenke, Kurt

AU - Callahan, Christopher

AU - Hui, Siu

AU - Williams, John W.

AU - Unützer, Jürgen

PY - 2004/7

Y1 - 2004/7

N2 - Although hypothyroidism is purportedly an important cause of depression, prior studies have involved small samples of young people and produced conflicting results. We examined the yield of thyroid-stimulating hormone (TSH) testing in a large group of elderly patients with major depression or dysthymic disorder. The study sample comprised 883 outpatients aged 60 years or older from 18 primary care sites enrolled in the intervention arm of a clinical trial of depression management. Thyroid function was assessed by a single TSH value. Depressive diagnoses were confirmed with the Structured Clinical Interview for DSM-IV (SCID) and depression severity was assessed with the HSCL-20, a modified depression scale of the Hopkins Symptom Checklist. TSH results were available for 725 (82.1%) participants. Although 32 (4.4%) of those tested had TSH>5 mIU/L, the vast majority (27/32) had marginally elevated results (5.1-9.4 mIU/L). Only five patients (0.7%) had TSH levels >10 mIU/L. Patients with elevated TSH did not differ from those with TSH≤5 mIU/L in the severity or symptom pattern of depression as measured by the baseline HSCL-20 score (P=.37) or SCID score (P=.44). These findings should caution physicians against acceptance of borderline TSH values as the primary cause of a patient's clinical depression.

AB - Although hypothyroidism is purportedly an important cause of depression, prior studies have involved small samples of young people and produced conflicting results. We examined the yield of thyroid-stimulating hormone (TSH) testing in a large group of elderly patients with major depression or dysthymic disorder. The study sample comprised 883 outpatients aged 60 years or older from 18 primary care sites enrolled in the intervention arm of a clinical trial of depression management. Thyroid function was assessed by a single TSH value. Depressive diagnoses were confirmed with the Structured Clinical Interview for DSM-IV (SCID) and depression severity was assessed with the HSCL-20, a modified depression scale of the Hopkins Symptom Checklist. TSH results were available for 725 (82.1%) participants. Although 32 (4.4%) of those tested had TSH>5 mIU/L, the vast majority (27/32) had marginally elevated results (5.1-9.4 mIU/L). Only five patients (0.7%) had TSH levels >10 mIU/L. Patients with elevated TSH did not differ from those with TSH≤5 mIU/L in the severity or symptom pattern of depression as measured by the baseline HSCL-20 score (P=.37) or SCID score (P=.44). These findings should caution physicians against acceptance of borderline TSH values as the primary cause of a patient's clinical depression.

KW - Depression

KW - Hypothyroidism

KW - Primary healthcare

KW - Thyroid-stimulating hormone

UR - http://www.scopus.com/inward/record.url?scp=3242662782&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3242662782&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2004.03.007

DO - 10.1016/j.genhosppsych.2004.03.007

M3 - Article

C2 - 15234826

AN - SCOPUS:3242662782

VL - 26

SP - 302

EP - 309

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

IS - 4

ER -