The Coexistence of Depressive Syndrome Among Patients with Autoimmune Thyroid Pathology and Vitamin D Deficiency – A Mere Coincidence?

Abstract

Objectives: Depressive syndrome is commonly observed in patients with autoimmune thyroid diseases, often coexisting with specific endocrine symptoms. This study highlights a higher prevalence of depression in patients from urban environments, potentially influenced by occupational, educational, and psychosocial factors, as well as environmental endocrine disruptors. Depression may develop at any age, with increased frequency among older individuals due to chronic health conditions. Early identification using tools such as the Beck Depression Inventory can support timely intervention and appropriate treatment strategies.

Methods: This paper presents a clinical observational study involving 80 patients with autoimmune thyroid disease from the Dobrogea region, Romania. Participants were divided into two groups: Group 1 with chronic autoimmune thyroiditis (CAT, n=62) and Group 2 with Graves’ disease (GD, n=18), reflecting the lower prevalence of GD. Inclusion criteria required confirmed autoimmune thyroid disease and residence in Constanța County. Patients underwent clinical and paraclinical evaluations, including hormonal and antibody testing, as well as vitamin D level assessment. Depression was screened using the Beck Depression Inventory II (BDI-II), a 21-item tool used to assess the presence and severity of depressive symptoms, particularly in relation to vitamin D deficiency.

Results: The study found that depression was more prevalent among GD patients (66.7%) compared to those with CAT (53.2%), with higher incidence in urban areas and among older individuals. Increased depression severity was associated with lower vitamin D levels, higher ATPO and TRAb levels, and suboptimal thyroid function. Mild depression was most common and linked to vitamin D deficiency in both groups. The Beck Depression Inventory-II effectively captured varying depression degrees across clinical and biochemical parameters.

Conclusions: Depression is a common comorbidity in autoimmune thyroid disorders and should be systematically assessed, with a multidisciplinary approach and attention to vitamin D status using cost-effective screening methods.