Is Every Thyroid Antibody a Bad Sign?: The Complex Relationship of Antithyroid Antibodies and Obsessive-compulsive Symptoms
Ali Caykoylu1, Mustafa Ugurlu1, Esra Kabadayi Sahin1, Selcuk Akan2, Gorkem Karakas Ugurlu1, Ezgi Cisil Erdogan3, Emine Ulku Alkan4
1Department of Psychiatry, Ankara Yıldırım Beyazit University, Ankara, Turkiye
2Department of Internal Medicine, Ankara City Hospital, Ankara, Turkiye
3Department of Psychiatry, Ankara City Hospital, Ankara, Turkiye
4Department of Translational Medicine, Ankara Yıldırım Beyazit University, Ankara, Turkiye
Correspondence to: Esra Kabadayi Sahin
Department of Psychiatry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ihsan Dogramaci Bulvari, Universiteler Mahallesi, Cankaya/Ankara 06800, Turkiye
E-mail: ekabadayi06@gmail.com
ORCID: https://orcid.org/0000-0003-1320-0119
Received: October 4, 2022; Revised: January 7, 2023; Accepted: January 12, 2023; Published online: June 29, 2023.
© The Korean College of Neuropsychopharmacology. All rights reserved.

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Abstract
Objective: Several immunological factors are emphasized in the etiology of autoimmune thyroid diseases and obsessivecompulsive disorder. Obsessive-compulsive symptoms (OCS) are commonly seen in patients with autoimmune thyroid diseases. This study aims to evaluate the relationship between OCS and antithyroid antibodies.
Methods: The study included 145 patients with Hashimoto thyroiditis or Graves’ disease and 42 healthy controls. Thyroid function tests and serum thyroid autobody levels (anti-thyroglobulin [TG], anti-thyroid peroxidase [TPO], and anti-thyroid stimulating hormone [TSH]) of the patients were measured. The socio-demographic data and OCS of the participants were evaluated with Dimensional OCS (DOCS).
Results: DOCS scores were higher in patients than in the control group. There was not found a significant relationship between free T3, free T4, and TSH levels and DOCS scores. Anti-TG positivity in females was associated with lower DOCS scores. Anti-TPO positivity in males had a positive correlation with DOCS scores. There was no correlation between sex and the presence of anti-TSH in terms of OCS severity. Univariate analysis found the highest OCS scores in anti-TPO positive, anti-TG, and anti-TSH negative patients. The group with the lowest OCS scores was found to be anti-TG positive, anti-TPO, and anti-TSH negative patients.
Conclusion: OCS severity could be affected by different thyroid autoantibody profiles in patients with autoimmune thyroid diseases. While anti-TG serves a protective role against OCS in females, the presence of anti-TPO may worsen the OCS in men. Additionally, the co-existence of different antithyroid antibodies may affect the severity of OCS differently according to sex.
Keywords: Obsessive-compulsive disorder; Hashimoto disease; Graves disease; Autoimmunity; Autoantibodies

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