Post Partum Depression and Thyroid Function

Article excerpt

Objective: Risk of depression is particularly high for women during the prenatal period. Various investigators have attempted to establish a link between thyroid function and post partum depression. This study aimed to investigate whether thyroid function differs in women with postpartum depression compared to a control group.

Methods: In this case-control study, subjects were selected from Obstetrics & Gynecology and Psychiatric clinics of Kermanshah University of Medical Sciences. Forty eight patients suffering from postpartum depression according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition totally revised (DSM-IV-TR), and 65 normal controls underwent diagnostic evaluation by one trained psychiatrist using Structured Clinical Interview for DSM-IV-TR. Then, the demographic questionnaire and the Persian version of Edinburgh Postnatal Depression Scale (EPDS) were completed by the participants. Finally, their thyroid functions were assessed. Data analyses were done using the SPSS program 13.

Results: No statistically significant differences were observed between thyroid function tests and postpartum depression. According to multiple regression analysis with stepwise method, subjects with lower serum TSH, T3RU, T3 levels, younger age and longer period after delivery tended to have higher EPDS scores (P-value=0.008).

Conclusion:The present study reports that those women with postpartum depression had a no greater prevalence of thyroid dysfunction than the control subjects. It seems that thyroid dysfunction should be considered in women with postpartum depression individually, but the role of thyroid as an important cause of this condition is not yet established. This suggests that future studies should concentrate on this concept in postpartum depression.

Keywords: Postpartum depression, Postpartum period, Thyroid hormone,

Iran J Psychiatry 2011; 6: 117-120

Risk of depression is particularly high for women during the prinatal period, with 10 to 15 percent of postpartum women experiencing a major depressive episode during this time (1). According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition totally revised (DSM-IV-TR), (2) an episode of depression is considered to have postpartum onset if it begins within four weeks after delivery. However, onset within three months after delivery is the time frame commonly used by investigators on the basis of epidemiologic studies (3). It may have a deleterious effect on the woman's social and personal adjustment, her marital relationship, and the mother infant interaction.(4) Furthermore, maternal depression early in the infant's life may affect the child's psychological development with significant intellectual deficits as a result.(5-7) Various explanatory models on the etiology have been proposed; probably postpartum depression is a result of an interaction between genetic vulnerability, hormonal changes, and major life events.(8,9). Psychosocial stressors, prenatal risk factors, previous psychiatric history, complications during pregnancy, delivery, and the prenatal period are associated with an increased risk of postpartum depression. (10) Thyroid function is known to be affected during pregnancy (11), while the pathogenesis of postpartum mood disturbances remains unclear. However, various investigators have attempted to establish a link between thyroid function, usually accompanied by autoimmune thyroiditis, with postpartum mood disorders (12-14). Furthermore, both hypothyroidism and hyperthyroidism, even subclinical, may lead to depressive symptomatology (15, 16). This study aimed to investigate whether thyroid function differs in women with postpartum depression compared to a control group.

Materials and Method

We conducted a case-control study to assess thyroid function in postpartum depression. Forty eight patients suffering from postpartum depression according to DSM-IV-TR, and sixty five normal controls entered the study. …