Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-05T16:10:46.862Z Has data issue: false hasContentIssue false

Anxiety and depression, attention, and executive functions in hypothyroidism

Published online by Cambridge University Press:  26 August 2005

E.L. CONSTANT
Affiliation:
Department of Psychiatry, Université Catholique de Louvain, Bruxelles, Belgium
S. ADAM
Affiliation:
Neuropsychology Unit, University of Liège, Liège, Belgium
X. SERON
Affiliation:
Cognitive Neuroscience Unit, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
R. BRUYER
Affiliation:
Cognitive Neuroscience Unit, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
A. SEGHERS
Affiliation:
Department of Psychiatry, Université Catholique de Louvain, Bruxelles, Belgium
C. DAUMERIE
Affiliation:
Department of Endocrinology, Université Catholique de Louvain, Bruxelles, Belgium

Abstract

Background: Divergences in cognitive disturbances in hypothyroidism reported in the literature are a result of a methodological bias. Methods: By using a precise methodology, we examined attention and executive functions in hypothyroidism, verified the presence of anxiety and depressive symptoms in hypothyroidism, and examined the possible link between these symptoms and the cognitive disturbances (searching for attentional bias for words with a negative emotional valence). We administered a battery of cognitive tests to 23 participants who had undergone thyroidectomy for thyroid carcinoma: for the first time in an euthyroid state, then 3 weeks later (still in the euthyroid state) to assess the test/retest effect, and finally 4 weeks later in an hypothyroid state. We compared their performance with that of a group of 26 control participants who were also administered the same cognitive tests, also 3 times. Results: In hypothyroidism, the thyroid participants were more anxious and depressed than the controls and presented attentional and executive disturbances that reflected general slowing and difficulties in using their capacities of inhibition. However, they did not exhibit an attentional bias for words with a negative emotional valence. Conclusions: Contrary to what was expected, symptoms of anxiety and not symptoms of depression interfered with the cognitive performance of participants in hypothyroidism. (JINS, 2005, 11, 535–544.)

Type
Research Article
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Austin, M., Ross, M., Murray, C., O'Carroll, R.E., Ebmeier, K.P., & Goodwin, G.M. (1992). Cognitive function in major depression. Journal of Affective Disorders, 25, 2130.Google Scholar
Baldini, I.M., Vita, A., Mauri, M.C., Amodei, V., Carrisi, M., Bravin, S., & Cantalamessa, L. (1997). Psychopathological and cognitive features in subclinical hypothyroidism. Progress in Neuropsychopharmacology and Biological Psychiatry, 21, 925935.Google Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.Google Scholar
Boillet, D. & Szoke, A. (1998). Psychiatric symptoms as single manifestation of hypothyroidism. Encéphale, 24, 6568.Google Scholar
Bower, G.H. (1981). Mood and memory. American Psychology, 36, 129148.Google Scholar
Bradley, B.P., Mogg, K., Millar, N., & White, J. (1995). Selective processing of negative information: Effects of clinical anxiety, concurrent depression, and awareness. Journal of Abnormal Psychology, 104, 532536.Google Scholar
Broadbent, D.E., Broadbent, M.H.P., & Jones, J.L. (1986). Performance correlates of self-reported cognitive failure and obsessionality. British Journal of Clinical Psychology, 25, 285299.Google Scholar
Burmeister, L.A., Ganguli, M., Dodge, H.H., Toczek, T., DeKosty, S.T., & Nebes, R.D. (2001). Hypothyroidism and cognition: Preliminary evidence for a specific defect in memory. Thyroid, 11, 11771185.Google Scholar
Constant, E.L., De Volder, A.G., Ivanoiu, A., Bol, A., Labar, D., Seghers, A., Cosnard, G., Melin, J., & Daumerie, C. (2001). Cerebral blood flow and glucose metabolism in hypothyroidism: A positron emission tomography study. Journal of Clinical Endocrinology and Metabolism, 86, 38643870.Google Scholar
Constant, E.L., Adam, S., Gillain, B., Seron, X., Bruyer, R., & Seghers, A. (2005). Effects of sertraline on depressive symptoms and attentional and executive functions in major depression. Depression and Anxiety, 21, 7889.Google Scholar
Content, A. (1990). BRULEX: Une base de données lexicales informatisées pour le français écrit et parlé. Année psychologique, 90, 551566.Google Scholar
Cornblatt, B., Nezenweger, M., & Erlenmeyer-Kimling, L. (1989). The continuous performance test, identical pairs version: II. Contrasting attentional profiles in schizophrenic and depressed patients. Psychiatry Research, 29, 6585.Google Scholar
Denicoff, K.D., Joffe, R.T., Lakshmanan, M.C., Robbins, J., & Rubinow, D.R. (1990). Neuropsychiatric manifestations of altered thyroid state. American Journal of Psychiatry, 147, 9499.Google Scholar
Dugbartey, A.T. (1998). Neurocognitive aspects of hypothyroidism. Archives of Internal Medicine, 158, 14131418.Google Scholar
Elliott, R., Rubinsztein, J.S., Sahakian, B.J., & Dolan, R.J. (2002). The neural basis of mood-congruent processing biases in depression. Archives of General Psychiatry, 59, 597604.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1996). Structured clinical interview for DSM-IV axis I disorders (SCID), clinical version. Washington, DC: American Psychiatric Press.
Fox, E. (1994). Attentional bias in anxiety: A defective inhibition hypothesis. Cognition and Emotion, 8, 165195.Google Scholar
Fransson, A. (1977). On qualitative differences in learning IV: Effects of intrinsic motivation and extrinsic anxiety on process and outcome. British Journal of Educational Psychology, 47, 244257.Google Scholar
Gotlib, I.H., McLachlan, A.C., & Katz, A.N. (1988). Biases in visual attention in depressed and nondepressed individuals. Cognition and Emotion, 2, 185200.CrossRefGoogle Scholar
Haggerty, J.J., Evans, D.L., & Prange, A.J., Jr. (1986). Organic brain syndrome associated with marginal hypothyroidism. American Journal of Psychiatry, 143, 785786.Google Scholar
Idzihowski, C. & Baddeley, A. (1987). Fear and performance in novice parachutists. Ergonomics, 30, 14631474.Google Scholar
Jaeschke, R., Guyatt, G., Gerstein, H., Patterson, C., Molloy, W., Cook, D., Harper, S., Griffith, L., & Carbotte, R. (1996). Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? Journal of General Internal Medicine, 11, 744749.Google Scholar
MacLeod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95, 1520.Google Scholar
Mathews, A., Ridgeway, V., & Williamson, D.A. (1996). Evidence for attention to threatening stimuli in depression. Behaviour Research and Therapy, 34, 695705.Google Scholar
McDermott, M.T. & Ridgway, E.C. (2001). Subclinical hypothyroidism is mild thyroid failure and should be treated. Journal of Clinical Endocrinology and Metabolism, 86, 45854590.Google Scholar
Merriam, E.P., Thase, M.E., Haas, G.L., Keshavan, M.S., & Sweeney, J.A. (1999). Prefrontal cortical dysfunction in depression determined by Wisconsin card sorting test performance. American Journal of Psychiatry, 156, 780782.Google Scholar
Mogg, K., Bradley, B.P., & Williams, R. (1995). Attentional bias in anxiety and depression: The role of awareness. British Journal of Clinical Psychology, 34, 1736.Google Scholar
Mogg, K., Bradley, B.P., Williams, R., & Mathews, A. (1993). Subliminal processing of emotional information in anxiety and depression. Journal of Abnormal Psychology, 102, 304311.Google Scholar
Monzani, F., Del Guerra, P., Caraccio, N., Pruneti, C.A., Pucci, E., Luisi, M., & Baschieri, L. (1993). Subclinical hypothyroidism: Neurobehavioral features and beneficial effect of L-thyroxine treatment. Journal of Clinical Investigation, 71, 367371.Google Scholar
Murphy, F.C., Sahakian, B.J., Rubinsztein, J.S., Michael, A., Rogers, R.D., Robbins, T.W., & Paykel, E.S. (1999). Emotional bias and inhibitory control processes in mania and depression. Psychological Medicine, 29, 13071321.Google Scholar
Nelson, E.B., Sax, K.W., & Strakowski, S.M. (1998). Attentional performance in patients with psychotic and nonpsychotic major depression and schizophrenia. American Journal of Psychiatry, 155, 137139.Google Scholar
Osterweil, D., Syndulko, K., Cohen, S.N., Pettler-Jennings, P.D., Hershman, J.M., Cummings, J.L., Tourtelotte, W.W., & Solomon, D.H. (1992). Cognitive function in non-demented older adults with hypothyroidism. Journal of American Geriatric Society, 40, 325335.Google Scholar
Reed, G.F. (1977). Obsessional cognition: Performance on two numerical tasks. British Journal of Psychiatry, 130, 184185.Google Scholar
Schneider, W., Eschman, A., & Zuccolotto, A. (2002). E-Prime user's guide. Pittsburgh, PA: Psychology Software Tools Inc.
Silberman, E., Weingartner, H., & Post, R.M. (1983). Thinking disorder in depression. Archives of General Psychiatry, 40, 775780.Google Scholar
Spielberger, C.D., Gorsuch, R.L., Lushene, R., Vagg, P.R., & Jacobs, G.A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Stroop, J.R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643662.Google Scholar
Volans, P.J. (1976). Styles of decision-making and probability appraisal in selected obsessional and phobic patients. British Journal of Social and Clinical Psychology, 15, 305317.Google Scholar
Whalen, P.J., Bush, G., McNally, R.J., Wilhelm, S., McInerney, S.C., Jenike, M.A., & Rauch, S.L. (1998). The emotional counting Stroop paradigm: A functional magnetic resonance imaging probe of the anterior cingulate affective division. Biological Psychiatry, 44, 12191228.Google Scholar
Whybrow, P.C. (1996). Behavioral and psychiatric aspects of hypothyroidism. In L.E. Braverman & R.D. Utiger (Eds.), The thyroid (Werner & Ingbar's 7th ed., pp. 866869). Philadelphia: Lippincott-Raven.
Zimmermann, P. & Fimm, B. (1994). Tests d'évalution de l'attention (TEA)–Version 1.02C. French adaptation by P. North, M. Leclercq, N. Cremel, P. Tassi, D. Jeromin (Eds). Herzogenrath, Germany: Psytest.