Intelligence Quotient, Anxiety, and Depression in Congenital Hypothyroid Children at School Age

Mitra Nekouei, Alireza Firoozfar, Dorna Kheirabadi, Sadegh Baradaran Mahdavi, Ali Talebi, Manizheh Danesh, Maryam Yahay, Mahdokht Rahimi, Laya Golshani, Gholam Reza Kheirabadi, Mahin Hashemipour

Abstract


Background: Many studies who evaluated the outcome of the congenital hypothyroidism (CH) screening reported some intellectual and behavioral deficit despite early diagnose and treatment. The aim of the present study was to compare the intellectual and behavioral adjustment of CH children with controls.

Methods: This study was conducted among a group of 135 children aged 8‑‑12 years in Isfahan, including transient and permanent congenital hypothyroidism (TCH and PCH) and a matched group of their classmate. Demographic characteristics collected using a designed data collecting form completed by parents. Intellectual quotient (IQ) was evaluated using Wechsler Intelligence Scale for Children aged 6‑‑16 years (WISC‑III). Depression and anxiety were evaluated using The Children’s Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC), respectively. The SPSS software version 20.0 was used for data analysis. Nonparametric tests (Mann‑‑Whitney) were used to investigate the association between variables. A significant level of less than 0.05 was considered in all analyzes.

Results: There was no significant difference in the IQ scores between PCH and TCH groups (P = NS). However, neither of them had intellectual disability (defined as IQ <70). IQ scores were significantly lower in PCH comparing to controls (P < 0.001). Total IQ and verbal IQ were significantly differenct between TCH and control group (P = 0.007 and P = 0.001). No significant difference was found in anxiety and depression scores between CH children and controls.

Conclusions: There is no significant difference in anxiety and depression scores between congenital hypothyroidism children and controls, although IQ scores in children with congenital hypothyroidism is lower than controls.


Keywords


Anxiety; congenital hypothyroidism; depression; intelligence

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References


Morreale de Escobar G, Obregon MJ, Escobar del Rey F.

Maternal‑fetal thyroid hormone relationships and the fetal brain.

Acta Med Austriaca 1988;15:66‑70.

Hashemipour M, Amini M, Iranpour R, Sadri GH, Javaheri N,

Haghighi S, et al. Prevalence of congenital hypothyroidism in

Isfahan, Iran: Results of a survey on 20,000 neonates. Horm Res

Paediatr 2004;62:79‑83.

Ordookhani A, Minniran P, Najafi R, Hedayati M, Azizi F.

Congenital hypothyroidism in Iran. Indian J Pediatr

;70:625‑8.

Hashemipour M, Hovsepian S, Kelishadi R, Iranpour R,

Hadian R, Haghighi S, et al. Permanent and transient congenital

hypothyroidism in Isfahan–Iran. J Med Screen 2009;16:11‑6.

Simoneau‑Roy J, Marti S, Deal C, Huot C, Robaey P,

Van Vliet G. Cognition and behavior at school entry in children

with congenital hypothyroidism treated early with high‑dose

levothyroxine. J Pediatr 2004;144:747‑52.

Ordooei M, Mottaghipisheh H, Fallah R, Rabiee A. Cognitive

outcomes for congenital hypothyroid and healthy children:

A comparative study. Iran J Child Neurol 2014;8:28‑32.

Kik E, Noczyńska A. Evaluation of mental development of

children with congenital hypothyroidism detected in screening

test‑‑personal observations. Pediatr Endocrinol Diabetes Metabol

;16:100‑8.

Dubuis J‑M, Glorieux J, Richer F, Deal C, Dussault J,

Van Vliet G. Outcome of severe congenital hypothyroidism:

Closing the developmental gap with early high dose levothyroxine

treatment. J Clin Endocrinol Metabol 1996;81:222‑7.

Huo K, Zhang Z, Zhao D, Li H, Wang J, Wang X, et al.

Risk factors for neurodevelopmental deficits in congenital

hypothyroidism after early substitution treatment. Endocr J

;58:355‑61.

Panicker V, Evans J, Bjøro T, Åsvold BO, Dayan CM,

Bjerkeset O. A paradoxical difference in relationship between

anxiety, depression and thyroid function in subjects on and

not on T4: Findings from the HUNT study. Clin Endocrinol

;71:574‑80.

Bauer M, Heinz A, Whybrow P. Thyroid hormones, serotonin

and mood: Of synergy and significance in the adult brain. Mol

Psychiatry 2002;7:140.

Saravanan P, Visser TJ, Dayan CM. Psychological well‑being

correlates with free thyroxine but not free 3, 5, 3′‑triiodothyronine

levels in patients on thyroid hormone replacement. J Clin

Endocrinol Metabol 2006;91:3389‑93.

Tinelli F, Costagli C, Bargagna S, Marcheschi M, Parrini B,

Perelli V. Behavioural disorders in adolescents with early‑treated

congenital hypothyroidism. Funct Neurol 2003;18:161‑4.

Rose SR, Brown RS, Pediatrics AAo, Association AT. Update of

newborn screening and therapy for congenital hypothyroidism.

Pediatrics 2006;117:2290‑303.

Jazayeri AR, Poorshahbaz A. Reliability and validity of wechsler

intelligence scale for children third edition (WISC-III) in Iran.

J Med Educ 2003;75-80.

March JS, Parker JD, Sullivan K, Stallings P, Conners CK. The

multidimensional anxiety scale for children (MASC): Factor

structure, reliability, and validity. J Am Acad Child Adolesc

Psychiatry 1997;36:554‑65.

Dehshiri G, Najafi M, Shikhi M, Habibi Askarabd M.

Investigating primary psychometric properties of children’s

depression inventory (CDI). J Fam Res 2009;5:159‑77.

Bisacchi N, Bal MO, Nardi L, Bettocchi I, D'Addabbo G,

Conti V, et al. Psychological and behavioural aspects in children

and adolescents with congenital hypothyroidism diagnosed by

neonatal screening: Comparison between parents' and children's

perceptions. Eur J Endocrinol 2011;164:269-76.

Mashhadi A, Soltani SR, Mirdoraghi F, Bahrami B. Psychometric

properties of the multidimensional anxiety scale for Iranian

children. J Appl Psychol 2012;6:70‑87. [In Persian].

Roberts LM, Pattison H, Roalfe A, Franklyn J, Wilson S,

Hobbs FR, et al. Is subclinical thyroid dysfunction in the elderly

associated with depression or cognitive dysfunction? Ann Inter

Med 2006;145:573‑81.

Salerno M, Militerni R, Di Maio S, Bravaccio C, Gasparini N,

Tenore A. Intellectual outcome at 12 years of age in congenital

hypothyroidism. Eur J Endocrinol 1999;141:105‑10.

Albert BB, Heather N, Derraik JG, Cutfield WS, Wouldes T,

Tregurtha S, et al. Neurodevelopmental and body composition

outcomes in children with congenital hypothyroidism treated

with high‑dose initial replacement and close monitoring. J Clin

Endocrinol Metab 2013;98:3663‑70.

Grüters A, Liesenkötter K, Zapico M, Jenner A, Dütting C,

Pfeiffer E, et al. Results of the screening program for congenital

hypothyroidism in Berlin (1978–1995). Exp Clin Endocrinol

Diabetes 1997;105:28‑31.

LaFranchi SH, Austin J. How should we be treating children

with congenital hypothyroidism? J Pediatr Endocrinol Metab

;20:559‑78.

Derksen‑Lubsen G, Verkerk P. Neuropsychologic development

in early treated congenital hypothyroidism: Analysis of literature

data. Pediatr Res 1996;39:561.

Holmes AM, Deb P. The effect of chronic illness on the

psychological health of family members. J Ment Health Policy

Econ 2003;6:13‑22.