Considering the possible adverse effects of thyroid autoantibodies on the brain, the present study aimed to investigate whether there was a difference in mental health difficulties and mindfulness awareness levels between subclinical Hashimoto’s thyroiditis patients with and without levothyroxine (LT4) use. A case-control study was conducted. The Strengths and Difficulties Questionnaire (SDQ) and the Mindful Attention Awareness Scale (MAAS) were used to screen mental health difficulties and mindfulness awareness. Scale scores were compared by performing correlation analysis between the groups with respect to LT4 use and thyroid autoantibodies. Levothyroxine alone does not affect scale results. Higher thyroid peroxidase antibody (TPOAb) titers were positively correlated with the behavioral problems subscale of the SDQ, while awareness level in patients was inversely correlated with higher thyroglobulin antibody (TgAb) levels.
Szczapa-JagustynJGotz-WięckowskaAKocięckiJ.An update on thyroid-associated ophthalmopathy in children and adolescents. J Pediatr Endocrinol Metab. 2016;29(10):1115-1122. doi:10.1515/jpem-2016-0122.
2.
TaubnerKSchubertGPulzerF, et al. Serum concentrations of anti-thyroid peroxidase and anti-thyroglobulin antibodies in children and adolescents without apparent thyroid disorders. Clin Biochem. 2014;47(1-2):3-7. doi:10.1016/j.clinbiochem.2013.09.017.
3.
PilhatschMMarxenMWinterC, et al. Hypothyroidism and mood disorders: integrating novel insights from brain imaging techniques. Thyroid Res. 2011;4:1-7.
4.
Carreón-RodríguezAPérez-MartínezL.Clinical implications of thyroid hormones effects on nervous system development [published correction appears in Pediatr Endocrinol Rev. 2012;9(4):744]. Pediatr Endocrinol Rev. 2012;9(3):644-649.
5.
CalzàLBaldassarroVAFernandezMGiulianiALorenziniLGiardinoL.Thyroid hormone and the white matter of the central nervous system: from development to repair. Vitam Horm. 2018;106:253-281.
6.
BauerMGoetzTGlennTWhybrowPC.The thyroid-brain interaction in thyroid disorders and mood disorders. J Neuroendocrinol. 2008;20(10):1101-1114.
7.
BauerMSilvermanDHSchlagenhaufF, et al. Brain glucose metabolism in hypothyroidism: a positron emission tomography study before and after thyroid hormone replacement therapy. J Clin Endocrinol Metab. 2009;94(8):2922-2929.
8.
Jurado -FloresMWardaFMooradianA. Pathophysiology and clinical features of neuropsychiatric manifestations of thyroid disease. J Endocr Soc. 2022;6:bvab194. doi:10.1210/jendso/bvab194.
9.
BiondiBCooperDS.The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29:76-131.
10.
BauerAJWassnerAJ.Thyroid hormone therapy in congenital hypothyroidism and pediatric hypothyroidism. Endocrine. 2019;66(1):51-62.
11.
NeyziOBundakRGökçayG, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol. 2015;7(4):280-293.
12.
IttermannTVölzkeHBaumeisterSEAppelKGrabeHJ.Diagnosed thyroid disorders are associated with depression and anxiety. Soc Psychiatry Psychiatr Epidemiol. 2015;50(9):1417-1425.
13.
ÖzyeşilZArslanCKesici Engin DenizŞM.Adaptation of the mindful attention awareness scale into Turkish. Educ Sci. 2011;36:224-235.
14.
GoodmanR.Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337-1345. doi:10.1097/00004583-200111000-00015.
15.
GüvenirTÖzbekABaykaraBArkarHŞentürkBİncekaşS.Psychometric properties of the Turkish version of the strengths and difficulties questionnaire (SDQ). Turk J Child Adolesc Ment Health. 2008;15:65-74.
16.
SerpaJGTaylorSLTillischK.Mindfulness-based stress reduction (MBSR) reduces anxiety, depression, and suicidal ideation in veterans. Med Care. 2014;52(12)(suppl 5):S19-S24. Accessed May 29, 2023. https://www.jstor.org/stable/26417875.
17.
HussainNSaidASA. Mindfulness-based meditation versus progressive relaxation meditation: impact on chronic pain in older female patients with diabetic neuropathy. J Evid Based Integr Med. 2019;24:2515690X19876599.
18.
OkadaNIwamaSOkujiT, et al. Anti-thyroid antibodies and thyroid echo pattern at baseline as risk factors for thyroid dysfunction induced by anti-programmed cell death-1 antibodies: a prospective study. Br J Cancer. 2020;122(6):771-777.
19.
LaursenBCollinsWA.Parent-child relationships during adolescence. In: LernerRMSteinbergL, eds Handbook of Adolescent Psychology. Hoboken, NJ: John Wiley & Sons, Inc.; 2009. doi:10.1002/9780470479193.adlpsy002002.
20.
CompasBEJaserSSDunnMJRodriguezEM.Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol. 2012;8:455-480.
21.
CartaMGLoviselliAHardoyMC, et al. The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: a field of interest for public health in the future. BMC Psychiatry. 2004;4:25.
22.
PopVJMaartensLHLeusinkG, et al. Are autoimmune thyroid dysfunction and depression related?J Clin Endocrinol Metab. 1998;83(9):3194-3197. doi:10.1210/jcem.83.9.5131.
23.
LeyheTMüssigKWeinertC, et al. Increased occurrence of weaknesses in attention testing in patients with Hashimoto’s thyroiditis compared to patients with other thyroid illnesses. Psychoneuroendocrinology. 2008;33(10):1432-1436.
24.
FavaAOliverioRGiulianoS, et al. Clinical evolution of autoimmune thyroiditis in children and adolescents. Thyroid. 2009;19(4):361-367. doi:10.1089/thy.2008.0239.
25.
MooreDC.Natural course of “subclinical” hypothyroidism in childhood and adolescence. Arch Pediatr Adolesc Med. 1996;150(3):293-297. doi:10.1001/archpedi.1996.02170280063012.
26.
AversaTCorriasASalernoM, et al. Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto’s thyroiditis presenting with either euthyroidism or subclinical hypothyroidism. Thyroid. 2016;26(10):1450-1456. doi:10.1089/thy.2016.0080.
27.
CrisafulliGAversaTZirilliG, et al. Subclinical hypothyroidism in children: when a replacement hormonal treatment might be advisable. Front Endocrinol (Lausanne). 2019;10:109. doi:10.3389/fendo.2019.00109.
28.
LeeHSHwangJS.The natural course of Hashimoto’s thyroiditis in children and adolescents. J Pediatr Endocrinol Metab. 2014;27(9-10):807-812. doi:10.1515/jpem-2013-0373.
29.
WangSYTungYCTsaiWYLeeJSHsiaoPH.Long-term outcome of hormonal status in Taiwanese children with Hashimoto’s thyroiditis. Eur J Pediatr. 2006;165(7):481-483. doi:10.1007/s00431-006-0112-5.
30.
WasniewskaMSalernoMCassioA, et al. Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence. Eur J Endocrinol. 2009;160(3):417-421.
31.
EffraimidisGWiersingaWM.Mechanisms in endocrinology: autoimmune thyroid disease: old and new players. Eur J Endocrinol. 2014;170(6):R241-R252. doi:10.1530/EJE-14-0047.
HollowellJGStaehlingNWFlandersWD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-499. doi:10.1210/jcem.87.2.8182.
