Somatic Causes Were Omitted
In their description of the causes the authors go into great detail about psychopathological and psychosocial causes but completely omit any mention of somatic causes of peripartum depression. In addition to rare endocrine disorders, such as primary hyperparathyroidism or endogenous hypercortisolism, postpartum thyroiditis is a clinically relevant disorder that may be accompanied by symptoms of depression. In 5–7% of all births worldwide, women develop autoimmune postpartum thyroiditis, with higher incidence rates in women with pre-existing and confirmed raised thyroid antibody concentrations. The disorder usually starts in the third or fourth month post partum. 25–30% of women develop functional disorders of the thyroid gland, mostly hypothyroidism, and more rarely, initial hyperthyroidism that resolves spontaneously. Not only patients with functional disorders have clinical symptoms; patients with euthyroidism also feel worse than healthy controls. Endocrine causes of postpartum depression should always be considered since excellent therapeutic options are available.
Priv.-Doz. Dr. med. Joachim Feldkamp
Klinik für Allgemeine Innere Medizin, Endokrinologie und Diabetologie,
Pneumologie und Infektiologie, Klinikum Bielefeld
Prof. Dr. med. Matthias Schott
Klinik für Endokrinologie und Diabetologie, Rheumatologie
Conflict of interest statement
The authors declare that no conflict of interest exists.
|1.||Lazarus JH: Clinical manifestations of postpartum thyroid disease. Thyroid 1999; 9: 685–9. CrossRef MEDLINE|
|2.||Stagnaro-Green A: Approach to the patient with postpartum thyroiditis. J Clin Endocrinol Metab 2012; 97: 334–42. CrossRef MEDLINE|
|3.||Pilhatsch M, Marxen M, Winter C, Smolka MN, Bauer M: Hypothyroidism and mood disorders: integrating novel insights from brain imaging techniques Thyroid Res. 2011; 4(Suppl 1): 3. MEDLINE|
|4.||Hübner-Liebermann B, Hausner H, Wittmann M: Recognizing and treating peripartum depression. Dtsch Arztebl Int 2012; 109(24): 419–24. VOLLTEXT|