THYROID DYSFUNCTION AND MENTAL HEALTH: A SYSTEMATIC REVIEW OF PSYCHIATRIC SYMPTOMS ASSOCIATED WITH HYPO- AND HYPERTHYROIDIS
DOI:
https://doi.org/10.56238/levv16n53-091Keywords:
Thyroid Diseases, Mood Disorders, Cognitive Dysfunction, Psychotic DisordersAbstract
Introduction: Thyroid dysfunction, encompassing both hypo- and hyperthyroid states, exerts profound systemic effects that extend to mood, cognition, and behavior. Psychiatric manifestations such as depression, anxiety, and psychosis have been consistently reported, yet their magnitude and mechanisms remain debated.
Objective: To systematically evaluate current evidence regarding psychiatric symptoms associated with thyroid dysfunction, emphasizing the spectrum of mood and cognitive alterations in overt and subclinical forms.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP for studies published from 2018 to 2025. Eligible studies included randomized trials, cohorts, and case-control designs assessing psychiatric outcomes in thyroid dysfunction. No language restrictions were applied. Data were synthesized qualitatively, with risk of bias and evidence certainty graded according to GRADE criteria.
Results and Discussion: Among 1,247 records identified, 52 studies met inclusion criteria. Hypothyroidism was strongly associated with depressive and cognitive symptoms, while hyperthyroidism correlated with anxiety, irritability, and in severe cases, psychotic or manic states. Subclinical conditions demonstrated weaker but consistent associations with mood and cognitive impairment. Immunological mechanisms and altered serotonergic neurotransmission emerged as plausible pathophysiological links. Heterogeneity in diagnostic criteria and outcome measures limited meta-analytic synthesis.
Conclusion: Psychiatric symptoms are clinically relevant manifestations of thyroid dysfunction. Routine thyroid screening in atypical or treatment-resistant psychiatric presentations is warranted. Integrative management addressing both endocrine and neuropsychiatric dimensions improves patient outcomes.
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