Abstract
Background: We assessed the prevalence of thyroperoxidase antibodies (TPO-Abs) and
thyroid failure in outpatients with bipolar disorder compared with two control groups.
Methods: The TPO-Abs of outpatients with DSM-IV bipolar disorder (n = 226), a population control group (n = 252), and psychiatric inpatients of any diagnosis (n = 3190) were measured. Thyroid failure was defined as a raised thyroid stimulating
hormone level, previously diagnosed hypothyroidism, or both. Subjects were compared
with attention to age, gender, and exposure to lithium.
Results: The TPO-Abs were more prevalent in bipolar patients (28%) than population
and psychiatric controls (3–18%). The presence of TPO-Abs in bipolar patients was
associated with thyroid failure, but not with age, gender, mood state, rapid cycling,
or lithium exposure. Thyroid failure was present in 17% of bipolar patients and more
prevalent in women. It was associated with lithium exposure, especially in the presence
of TPO-Abs, but not with current rapid cycling, although an association may have been
masked by thyroid hormone replacement.
Conclusions: Thyroid autoimmunity was highly prevalent in this sample of outpatients
with bipolar disorder and not associated with lithium treatment. These variables appear
to be independent risk factors for the development of hypothyroidism, especially in
women with bipolar disorder.
Keywords
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Article info
Publication history
Accepted:
June 8,
2001
Received in revised form:
May 30,
2001
Received:
March 1,
2001
Identification
Copyright
© 2002 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
