ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Anxiety and Stress Disorders
Role of thyroid dysfunction in long-term psychological prognosis of sepsis
Provisionally accepted
- Henan Provincial People's Hospital, Henan, China
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Abstract Background After recovery from sepsis, approximately 10%-50% of patients develop long-term psychological complications such as anxiety, depression, and post-traumatic stress disorder, yet predictive indicators for these complications remain unclear. Emerging evidence suggests that thyroid function may hold prognostic value for sepsis itself. Building on this evidence, the present study aims to investigate the impact of baseline peripheral thyroid indicators on long-term psychological outcomes (within 28 weeks) in sepsis patients. Methods A consecutive sample of 814 sepsis patients was included. Baseline data including demographic characteristics, thyroid function indices, and peripheral inflammatory markers were collected, and psychological outcomes within 28 weeks of follow-up (i.e., anxiety, depression, and post-traumatic stress disorder) were evaluated. ROC analysis, Kaplan-Meier survival analysis, and multivariate COX regression were employed for analysis. Results (1) Higher levels of peripheral TT3, FT3, TT4, and FT4 at baseline were correlated with a reduced risk of poor psychological outcomes within 28 weeks. Sepsis-induced hypothyroidism was associated with an increased risk of poor psychological outcomes within 28 weeks. (2) These associations appeared to be more pronounced in elderly patients. (3) Peripheral TSH levels showed no such predictive value; similarly, "low-normal thyroid function" (defined as relatively high peripheral TSH within the normal range) also lacked predictive value. (4) A negative monotonic relationship was observed between baseline peripheral thyroid hormones and peripheral levels of tumor necrosis factor-α, interleukin-6, and interleukin-8. Conclusion Diminished thyroid function may be associated with relatively poor long-term psychological outcomes (within 28 weeks) in sepsis patients, possibly more so in the elderly. Given the observed association between thyroid hormones and peripheral inflammatory factors, this potential prognostic relationship may be partially mediated by inflammatory mechanisms. However, this remains a preliminary speculation and requires further validation.
Keywords: Anxiety, Depression, Post-traumatic stress disorder, Sepsis, Thyroiddysfunction
Received: 04 Sep 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Zhao, Hu, Jia, Zhang and Shao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huanzhang Shao, shaohuanzhang202009@outlook.com
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