The Influence of Depressive Syndrome on the Occurrence of Gallstone Disease in Reproductive-Age Women with Subclinical Hypothyroidism

Аннотация

Background: Subclinical hypothyroidism (SCH), depressive symptoms and gallstone disease may coexist in reproductive-age women, yet the nature and direction of their relationships remain uncertain. Objective: To critically examine evidence linking thyroid dysfunction, depressive syndrome and cholelithiasis, and to propose a clinically feasible strategy for testing whether depression is associated with gallstones among women with SCH. Methods: A focused narrative synthesis of clinical guidelines, observational studies, Mendelian-randomization analyses and mechanistic literature was undertaken. Results: Thyroid dysfunction may alter cholesterol handling, bile secretion and biliary motility. Studies in broader populations report associations between depressive symptoms and gallstones; a 2024 analysis of 7,707 participants found progressively higher odds across depression-severity categories. However, these estimates cannot be directly generalized to reproductive-age women with SCH, and causal inference remains limited. Conclusion: A combined endocrine, psychiatric and hepatobiliary assessment is biologically plausible and research-worthy, but a direct causal influence of depressive syndrome on gallstone occurrence in this specific population has not been established. Prospective studies with rigorous confounder control are needed.