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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
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
Table 2.
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 syndrome | 10 (30.3%) |
| Psychotic Syndrome | 19 ( 57.6%) |
| Depression syndrome | 5 (15.2%) |
| Catatonia | 10 (30.3%) |
| Exited | 6 (18.2%) |
| Stuporus | 2 (6.1%) |
| Fluctuating | 2 (6.1%) |
The most common clusters of Neuropsychiatric features
| NPI-Q | Positive Thyroid Autoantibodies(n=33) |
|---|---|
| Delusion | 15 (45.4%) |
| Agitation/Aggression | 14 (42.4%) |
| Irrıtability | 14 (42.4%) |
| Motor abnormality | 14 (42.4%) |
| Sleep disorder | 15 (45.4%) |
| Appetite/Eating | 14 (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
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- European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S278 - S279
- Creative Commons
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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