The relevant research of thyroid hormones and clinical features in treatment-resistant depression

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Objective To explore the clinical characteristics of treatment-resistant depression (TRD) and of its relevance with thyroid hormones. Methods 43 patients with TRD and 48 patients with non-TRD were assessed with 17-item Hamilton depression scale (HAMD-17) and Hamilton anxiety scale (HAMA). The serum level of thyroid-stimulating hormone (TSH), total triodothgronine (TT3), total thyroxine (TT4), free triodothgronine (FT3) and free thyroxine (FT4) were determined by radioimmunoassay. χ2 test and t test were used for statistic analysis. The quantitative relation of FT3 level with TRD was analyzed and the value of FT3 level in TRD diagnosis was evaluated by ROC curve. Results Compared with non-TRD patients, the TRD patients showed a younger disease onset age ((16.98±2.25)years vs (23.50±3.38)years) and a longer disease course ((10.14±6.47)years vs (5.48±4.15)years) for total disease course; (60.35±23.64)months vs (5.00±3.40)months for current disease course), and had shorter education years ((8.53±1.72)years vs (11.04±2.07)years) and higher HAMD total scores (19.09±1.59 vs 15.69±2.38) and behavior retarding factor scores (8.72±0.98 vs 4.98±1.63). In addition, the FT3 level of TRD patients was lower than that of non-TRD patients ((3.92±0.15)pmol/L vs (4.16±0.20)pmol/L). All the above differences between two groups were statistically significant (P<0.05). The logistic regression analysis showed that the risk of suffering TRD increased by 1.006-fold when FT3 level reduced 0.1 pmol/L (OR=2.006, 95%CI=(1.501, 2.681). The area under ROC curve was 0.821 (P<0.001) with its 95% confidence interval of (0.734, 0.907). Conclusion Compared with non-TRD patients, TRD patients have a longer disease course, a younger disease onset age, a lower education level, higher HAMD total scores, more severe retardation symptoms, and a lower FT3 level. The serum FT3 level has a high reference value in diagnosis of TRD. Key words: Treatment-resistant depression; Clinical features; Thyroid hormone

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