标题：心境障碍与自身免疫性甲状腺炎共病的相关研究进展

      作者：杨学平 综述 何茹 审校    中国医科大学人民医院(辽宁省人民医院)心理科，辽宁 沈阳 110016

      卷次： 2021年32卷5期

      【摘要】 心境障碍是一类常见的情感性疾病，包括双相情感障碍和抑郁障碍，可以与多种躯体疾病共病，从而延长疾病的病程，增加治疗的难度和费用。其中，与自身免疫性甲状腺炎(AIT)的共病在临床就很常见。由于甲状腺本身与情绪关联密切，心境障碍与AIT之间在疾病的发生发展过程中常相互影响，可相互增加两者的发生率，共病概率大。在心境障碍的患者中，更容易发生甲状腺功能异常，进而发展为AIT。而对于AIT的患者，也更容易表现出更差的心理状况，发生抑郁型心境障碍。目前，虽尚缺乏AIT患者中双相情感障碍发生率增加的证据，但也足以说明共同关注躯体及心理的必要性。对于两者共病的因素是多方面的，除一些常见因素外，还与神经内分泌、免疫系统等有关。而对于疾病的治疗，包括药物治疗、物理生物治疗及心理治疗等，但都需要考虑共病治疗的安全性和有效性。预防则需从病理机制的相关因素或疾病有关的风险因素方面，采取相应的可控措施，以减少的疾病发生。
      【关键词】 心境障碍；自身免疫性甲状腺炎；共病；治疗预防；综述
      【中图分类号】 R581.4 【文献标识码】 A 【文章编号】 1003—6350（2021）05—0657—05

Study on the combination of mood disorders and autoimmune thyroiditis.
YANG Xue-ping, HE Ru. Department ofPsychology, the People’s Hospital of China Medical University, the People’s Hospital of Liaoning Province, Shenyang110016, Liaoning, CHINA【Abstract】 Mood disorder is a common type of affective disorder, including bipolar affective disorder (BD) anddepression disorder, which can be co-disease with a variety of physical disorders, thus prolonging the course of the dis-eases and increasing the difficulty and cost of treatment. It is often in co-disease with autoimmune thyroiditis (AIT) clini-cally. Because thyroid gland itself is closely related to mood, mood disorders and AIT often affect each other in thecourse of the development, which increase the incidences of the diseases and co-disease. In patients with mood disor-ders, thyroid dysfunction is more likely to occur and develop into AIT. Patients with AIT were more likely to haveworse mental conditions and develop depressive mood disorder. At present, although there is no evidence supportingthe increase of bipolar disorder in AIT patients, it is sufficient to illustrate the necessity for attention to physical andpsychological conditions. There are many factors for the co-disease, and co-disease also is related to with neuroendo-crine and immune system in addition to some common factors. The treatments of diseases include drug therapy, physio-therapy, biotherapy and psychotherapy, but it is needed to consider the safety and effectiveness of these treatments. Pre-vention requires controllable measures to reduce the occurrence of diseases in terms of pathological mechanisms or dis-ease-related risk factors.
      【Key words】 Mood disorder; Autoimmune thyroiditis (AIT); Co-disease; Treatment and prevention; Review·综述·doi:10.3969/j.issn.1003-6350.2021.05.033