Proper Treatment in Children With Congenital Hypothyroidism Can Aid Behavior
Over- and undertreatment have been linked to attention-deficit hyperactivity disorder, autisti-form-like behavior.
Behavioral problems in children with congenital hypothyroidism can be mitigated through appropriate levels of treatment during infancy, according to research presented at the 87th Meeting of the American Thyroid Association, held October 18-22 in Victoria, BC, Canada.
Researchers at the Erasmus Medical Center and Sophia Children's Hospital in Rotterdam, The Netherlands, examined the relationships among congenital hypothyroidism, attention-deficit hyperactivity disorder, and autism in 55 children with congenital hypothyroidism from birth to age 11 years. At ages 6 and 11 years, parents and teachers completed the Child Behavior Checklist and the Teacher's Report Form; scores related to attention problems, delinquency, and aggression (ADA) and withdrawn, anxious, social, and thought problems (WAST) were associated with either over- or undertreatment of hypothyroidism.
Children overtreated for congenital hypothyroidism within 1 to 3 months of birth had mean 4 points higher ADA scores vs children who were not overtreated (95% CI, 2.30-5.71; P <.001). Those who were undertreated from 3 to 6 months after birth had mean 6.19 higher WAST scores vs not-undertreated children (95% CI, 4.23-8.16; P <.001). At 6 and 11 years, both ADA and WAST scores were comparable (P =.788 and .818, respectively), with a strong correlation (parents r=0.686 and 0.617, respectively; teachers r=0.818 and 0.575, respectively; P <.001 for all).
"[Patients with congenital hypothyroidism] showed behavioral problems," the researchers concluded. "Overtreatment in period 1-3 months postnatally led to [attention-deficit hyperactivity disorder]-like behavior, whereas undertreatment in period 3-6 months led to autisti-form behavior. These problems...seem permanent and possibly avoidable by adequate treatment."
Bongers-Schokking JJ, de Rijke YB, de Munick Keizer-Schrama SM. Relation between ADHD, autism, and congenital hypothyroidism. Presented at: 87th Annual Meeting of the American Thyroid Association; October 18-22, 2017; Victoria, BC, Canada. Poster 368.