Prevalence of psychotic symptoms and their clinical correlates in elderly major depressive disorder patients with subclinical hypothyroidism

Background: In patients with major depressive disorder (MDD), thyroid dysfunction is highly associated with depression severity and psychotic symptoms such as delusions and hallucinations. However, the prevalence and clinical correlates of psychotic symptomss in older MDD patients with subclinical hypothyroidism are rarely reported in China. Methods: We recruited 172 older patients with first-episode and untreated MDD (aged ≥ 50 years). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale positive subscale, and Global Impression of Severity Scale were used to assess depression, anxiety, psychotic symptoms, and disease severity, respectively. Results: The prevalence of psychotic symptomss was 18.6±0.2% (32/172) in older MDD patients with subclinical hypothyroidism. Thyroid stimulating hormone (TSH) and HAMA scores were clinical correlates for psychotic symptomss in older MDD patients with subclinical hypothyroidism. Conclusions: Our findings suggest that psychotic symptoms is common in older MDD patients with subclinical hypothyroidism. Higher TSH levels may indicate more psychotic symptoms in older MDD patients with subclinical hypothyroidism. Screening of serum thyroid hormones is crucial in older MDD patients.