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Int J Bipolar Disord. 2016 Dec;4(1):5. doi: 10.1186/s40345-016-0046-4. Epub 2016 Feb 11.

Bipolar disorder and antithyroid antibodies: review and case series.

Author information

1
Unit of Clinical Pharmacology, Section of Neurosciences, Department of Biomedical Sciences, "San Giovanni di Dio" Hospital, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. bocchett@unica.it.
2
Unit of Clinical Pharmacology, Section of Neurosciences, Department of Biomedical Sciences, "San Giovanni di Dio" Hospital, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. francesco.traccis@gmail.com.
3
Unit of Clinical Pharmacology, Section of Neurosciences, Department of Biomedical Sciences, "San Giovanni di Dio" Hospital, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. mosca@unica.it.
4
Department of Medical Sciences "Mario Aresu", University of Cagliari, Cagliari, Italy. aserra@medicina.unica.it.
5
Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. tamburin@unica.it.
6
Department of Medical Sciences "Mario Aresu", University of Cagliari, Cagliari, Italy. alovise@medicina.unica.it.

Abstract

Mood disorders and circulating thyroid antibodies are very prevalent in the population and their concomitant occurrence may be due to chance. However, thyroid antibodies have been repeatedly hypothesized to play a role in specific forms of mood disorders. Potentially related forms include treatment-refractory cases, severe or atypical depression, and depression at specific phases of a woman's life (early gestation, postpartum depression, perimenopausal). With regard to bipolar disorder, studies of specific subgroups (rapid cycling, mixed, or depressive bipolar) have reported associations with thyroid antibodies. Offspring of bipolar subjects were found more vulnerable to develop thyroid antibodies independently from the vulnerability to develop psychiatric disorders. A twin study suggested thyroid antibodies among possible endophenotypes for bipolar disorder. Severe encephalopathies have been reported in association with Hashimoto's thyroiditis. Cases with pure psychiatric presentation are being reported, the antithyroid antibodies being probably markers of some other autoimmune disorders affecting the brain. Vasculitis resulting in abnormalities in cortical perfusion is one of the possible mechanisms.

KEYWORDS:

Bipolar disorders; Depression; Hashimoto’s encephalopathy; Hashimoto’s thyroiditis; Lithium; Mood disorders; Thyroglobulin antibodies; Thyroid microsomal antibodies; Thyroid peroxidase antibodies

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