TY - JOUR
T1 - Hyperthyroidism and Risk for Bipolar Disorders
T2 - A Nationwide Population-Based Study
AU - Hu, Li Yu
AU - Shen, Cheng Che
AU - Hu, Yu Wen
AU - Chen, Mu Hong
AU - Tsai, Chia Fen
AU - Chiang, Huey Ling
AU - Yeh, Chiu Mei
AU - Wang, Wei Shu
AU - Chen, Pan Ming
AU - Hu, Tsung Ming
AU - Chen, Tzeng-Ji
AU - Su, Tung Ping
AU - Liu, Chia Jen
PY - 2013/8/30
Y1 - 2013/8/30
N2 - Background:Thyroid disorders have long been associated with psychiatric illness, often with symptoms suggestive of mood disorders. The most common clinical features associated with hyperthyroidism are anxiety and depression. The risk of bipolar disorders, especially bipolar mania, among patients with thyroid disorders has not been well characterized.Objective:We explored the relationship of hyperthyroidism and the subsequent development of bipolar disorders, and examined the risk factors for bipolar disorders in patients with hyperthyroidism.Methods:We identified patients who were diagnosed with hyperthyroidism between 2000 and 2010 in the Taiwan National Health Insurance Research Database. A comparison cohort without hyperthyroidism was matched based on age, sex, and comorbidities. The occurrence of bipolar disorders was evaluated in both cohorts based on diagnosis and the use of mood stabilizer drugs.Results:The hyperthyroidism cohort consisted of 21, 574 patients, and the comparison cohort consisted of 21, 574 matched control patients without hyperthyroidism. The incidence of bipolar disorders (incidence rate ratio [IRR], 2.31, 95% CI 1.80-2.99, P<.001) was higher for the hyperthyroidism patients than the control patients. Multivariate, matched regression models showed that women (HR 2.02, 95% CI 1.34-3.05, P =. 001), patients with alcohol use disorders (HR 3.03, 95% CI 1.58-5.79, P =. 001), and those with asthma (HR 1.70, 95% CI 1.18-2.43, P =. 004) were independent risk factors for the development of bipolar disorders in hyperthyroidism patients.Conclusions:Although a possibility that the diagnosis of bipolar disorders in this study actually includes "bipolar disorders due to hyperthyroidism" cannot be excluded, this study suggests that hyperthyroidism may increase the risk of developing bipolar disorders.
AB - Background:Thyroid disorders have long been associated with psychiatric illness, often with symptoms suggestive of mood disorders. The most common clinical features associated with hyperthyroidism are anxiety and depression. The risk of bipolar disorders, especially bipolar mania, among patients with thyroid disorders has not been well characterized.Objective:We explored the relationship of hyperthyroidism and the subsequent development of bipolar disorders, and examined the risk factors for bipolar disorders in patients with hyperthyroidism.Methods:We identified patients who were diagnosed with hyperthyroidism between 2000 and 2010 in the Taiwan National Health Insurance Research Database. A comparison cohort without hyperthyroidism was matched based on age, sex, and comorbidities. The occurrence of bipolar disorders was evaluated in both cohorts based on diagnosis and the use of mood stabilizer drugs.Results:The hyperthyroidism cohort consisted of 21, 574 patients, and the comparison cohort consisted of 21, 574 matched control patients without hyperthyroidism. The incidence of bipolar disorders (incidence rate ratio [IRR], 2.31, 95% CI 1.80-2.99, P<.001) was higher for the hyperthyroidism patients than the control patients. Multivariate, matched regression models showed that women (HR 2.02, 95% CI 1.34-3.05, P =. 001), patients with alcohol use disorders (HR 3.03, 95% CI 1.58-5.79, P =. 001), and those with asthma (HR 1.70, 95% CI 1.18-2.43, P =. 004) were independent risk factors for the development of bipolar disorders in hyperthyroidism patients.Conclusions:Although a possibility that the diagnosis of bipolar disorders in this study actually includes "bipolar disorders due to hyperthyroidism" cannot be excluded, this study suggests that hyperthyroidism may increase the risk of developing bipolar disorders.
UR - http://www.scopus.com/inward/record.url?scp=84883411290&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0073057
DO - 10.1371/journal.pone.0073057
M3 - Article
C2 - 24023669
AN - SCOPUS:84883411290
SN - 1932-6203
VL - 8
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e73057
ER -
