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Association of anti-thyroid autoantibodies with neuropsychiatric features in patients with affective and schizophrenia spectrum disorders

Published online by Cambridge University Press:  27 August 2024

R. S. Ilhan*
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
K. C. Can
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
S. N. Lalic
Affiliation:
2Psychiatry, Specil Psychiatric Hospital Department of Psychiatry Podvrsanska, psychiatry, Vrsac, Serbia
E. Halaman
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
O. Aktay
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
F. Özdemir
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
B. Çolak
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
B. Duman
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
S. Yazıcı
Affiliation:
3Psychiatry, mamak devlet hastanesi, ANKARA, Türkiye
M. C. Saka
Affiliation:
1Psychiatry, Ankara University, ANKARA, Türkiye
*
*Corresponding author.

Abstract

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Introduction

A growing body of evidence has shown the association between autoimmune thyroiditis and mental illness (Rege et al. AUS N J S Psychiatry 2013; 300 141-154). Identifying the neuropsychiatric features associated with thyroid antibody positivity could have significant implications for diagnostic and therapeutic strategies. However, the link between anti-thyroid antibodies and precise underlying pathophysiology requires future research.

Objectives

The aim of the present study was to conduct a retrospective evolution in patients diagnosed with schizophrenia spectrum disorder and affective disorder who were screened for anti-thyroid antibodies at the time of their hospitalization and to investigate neuropsychiatric features of anti-thyroid antibody-positive patients.

Methods

A total of 143  inpatients diagnosed with schizophrenia spectrum disorders and affective disorders between 2021 and 2023 were screened for anti-thyroid antibodies such as thyroid peroxidase (TPO) and thyroglobulin (TG). All patients were women. In order to elucidate the subsequent neuropsychiatric clinical features of individuals with positive anti-thyroid antibodies, the retrospective examination was conducted based on Neuropsychiatric Invetory-Q (NPI-Q) and DSM-V diagnostic criteria utilized at the time of hospitalization.

Results

The main age of the patients was 48.2 (SD 10.4). A total of 143 inpatients with schizophrenia spectrum disorders and affective disorders were screened for anti-thyroid antibodies at the time of their hospitalizations. %23.1 (n=33) tested positive for at least one of the anti-TG or anti-TPO. All patients were euthyroid. The neuropsychiatric diagnoses are shown in Table 1. The most common neuropsychiatric features assessed by NPI-Q are shown in Table 2. 12.1% (n=4) of all patients were treated with IV steroid Pulse therapy.Table 1.

Neuropsychiatric syndrom-level diagnostic patterns according to DSM-V

Patients with positive thyroid autoantibodies(n=33)
Manic syndrome10 (30.3%)
Psychotic Syndrome19 ( 57.6%)
Depression syndrome5 (15.2%)
Catatonia10 (30.3%)
   Exited6 (18.2%)
   Stuporus2 (6.1%)
   Fluctuating2 (6.1%)
Table 2.

The most common clusters of Neuropsychiatric features

NPI-QPositive Thyroid Autoantibodies(n=33)
Delusion15 (45.4%)
Agitation/Aggression14 (42.4%)
Irrıtability14 (42.4%)
Motor abnormality14 (42.4%)
Sleep disorder15 (45.4%)
Appetite/Eating14 (42.4%)

Conclusions

In particular, in a subset of schizophrenia spectrum disorder or affective disorder patients with positive anti-thyroid antibodies may indicate autoimmunity, especially in cases where catatonic symptoms dominate the clinical presentation.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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