Association between thyroid autoimmunity and antidepressant treatment-emergent mania in pediatric mood disorders

Dogukan Koc*, Ecem Ince, Tugba San, Pınar Akan, Ahu Paketci, Ece Bober, Nese Direk Tecirli, Neslihan Inal, Aynur Pekcanlar Akay

*Corresponding author for this work

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Risk factors associated with antidepressant treatment-emergent mania(ATEM) are poorly characterized in child and adolescent populations. To identify better biomarkers, we aimed to explore whether thyroid autoimmunity is associated with ATEM in pediatric mood disorders. We enrolled two groups of pediatric mood disorders, those with ATEM+ (n = 29) and those with ATEM- controls (n = 31). All diagnoses were made according to structured interviews by the clinicians. Autoimmune thyroiditis (anti-thyroid peroxidase antibodies [TPO-abs] and thyroid function (thyroid-stimulating hormone [TSH] and free thyroxin [FT4]) were assessed. Logistic regression was used to explore the relationship between TPO-abs seroprevalence and ATEM+ while controlling for covariates. Group comparisons showed that the patient with ATEM+ had significantly higher seroprevalence and titer of TPO-abs compared to ATEM- controls. In logistic regression analysis adjusting for age, gender, Tanner stage, body mass index, antipsychotic treatments, smoking status and family history of thyroid disorder, the seroprevalence of TPO-abs (>60 U/mL) was significantly associated with ATEM+ (OR = 3.67, 95% confidence interval [CI] = 1.2-11.1, p = 0.022). Our findings demonstrated that seroprevalence and titer of TPO-abs in pediatric mood disorders are associated with ATEM+ status. TPO-abs could potentially serve as a biomarker when assessing the risk of ATEM in the child and adolescent population.

Original languageEnglish
Article number114676
JournalPsychiatry Research
Publication statusPublished - Aug 2022

Bibliographical note

Funding Information:
This work was supported by Dokuz Eylul University Scientific Research Projects Coordination Unit, Izmir, Turkey ( 2019.KB.SAG.039 ). The funding sources had no role in the study design, data collection, analysis and interpretation of data, writing of the report, and in the decision to submit the article for publication.

Publisher Copyright:
© 2022


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