Antithyroid antibodies in depressive diseases

Whereas clinical relevant hypo- as well as hyperthyreosis are strongly susp ected to induce psychiatric symptoms, there is a controversy about the rele vance of only subclinical and autoimmune findings. We found autoantibodies (MAK, TAK, TRAK) in a high percentage (100 out of 144 = 70 %) in severely d epressed inpatients. Also we found a Hashimoto thyreoiditis in 5 patients. In the long run this may lead to relevant hypothyreosis which is regarded t o be a risk factor for depression and for possible non-response in medical treatment. We conclude that in cases of repeated depressive episodes especially depres sion of the elderly and in nonresponders it seems necessary not only to get lab for TSH, T3 and T4 but also to assess the autoimmune status of the thy roid gland (autoantibodies). There is further need for controlled studies whether there is a better outc ome in nonresponders to antidepressive medical treatment and positive autoa ntibody status after supplementation with triiodothyronine.