Korean J Fam Pract 2020; 10(3): 176-181  https://doi.org/10.21215/kjfp.2020.10.3.176
Association of Subclinical Hypothyroidism and Depression with Patient Health Questionnaire-9 in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey, 2014
Miseon Yoo1, Sunyoung Kim1, Chang Won Won1,2, Jinho Yoo1, Roji Oh1, Byung Sung Kim1,2,*
1Department of Family Medicine, Kyung Hee University Medical Center; 2Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
Byung Sung Kim
Tel: +82-2-958-8696, Fax: +82-2-958-8699
E-mail: byungskim@naver.com
ORCID: http://orcid.org/0000-0002-3293-9640
Received: July 30, 2018; Revised: September 30, 2019; Accepted: March 12, 2020; Published online: June 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Subclinical thyroid disease is characterized by abnormal thyroid stimulating hormone (TSH) levels with normal free thyroxine (T4) levels. This study aimed to verify the association between subclinical hypothyroidism and depression measured using the Patient Health Questionnaire-9 (PHQ-9) score in the Korean population.
Methods: This cross-sectional study included 1,786 adults aged ≥19 years with normal free T4 levels and serum TSH levels ≥0.45 mIU/L who had participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2014. The PHQ-9 was first introduced in the KNHANES to detect depression (PHQ score of ≥10). Serum TSH level of 0.45–4.49 mIU/L was defined as the reference range. The association between subclinical hypothyroidism and depression according to gender and age was evaluated using the binary logistic regression analysis after adjusting for age, education, and body mass index.
Results: There was no association between subclinical hypothyroidism and depression according to gender. The odds ratio for depression was 2.498 (95% confidence interval [CI], 0.905–6.895; P=0.077) in men and 0.727 (95% CI, 0.352–1.503; P=0.390) in women. Additionally, there was no association between subclinical hypothyroidism and depression according to age.
Conclusion: These results suggest that subclinical hypothyroidism was not associated with depression in Korean adults.
Keywords: Hypothyroidism; Depression; Surveys and Questionnaires
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