Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (1): 37-42.doi: 10.6040/j.issn.1671-7554.0.2025.0229

• Special Issue—Mechanistic Evidence and Clinical Translation in Mental and Sleep Disorders • Previous Articles     Next Articles

Prediction of aggression behavior in bipolar disorder patients by thyroid hormone and cortisol levels

ZHOU Chaoxiong, FU Yi   

  1. Jiangxi Provincial Mental Hospital / Nanchang University Affiliated Mental Hospital, Nanchang 330029, Jiangxi, China
  • Published:2026-01-27

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Abstract: Objective To explore the relationship between serum levels of thyroxine(T4), triiodothyronine(T3), cortisol(Cor), and the insight of patients with bipolar disorder(BD), and to analyze their predictive value for aggressive behavior in patients. Methods A total of 184 BD patients admitted to Jiangxi Mental Hospital from June 2021 to June 2024 were selected and divided into an aggressive behavior group(71 cases)and a non-aggressive behavior group(113 cases)based on the presence or absence of aggressive behavior. Additionally, 70 healthy individuals were selected as a control group during the same period. Serum levels of T4, T3, and Cor were measured. The insight and treatment attitudes questionnaires(ITAQ)were used to assess the patients insight. Pearson correlation analysis was used to analyze the correlation between serum levels of T4, T3, Cor, and insight in BD patients. Logistic regression analysis was used to analyze the risk factors for aggressive behavior in BD patients. The predictive value of serum T4, T3, and Cor levels for aggressive behavior in BD patients was analyzed by receiver operating characteristic(ROC)curves. Results The serum levels of T4, T3, and Cor in the aggressive behavior group were higher than those in the non-aggressive behavior group, and the ITAQ score was lower than that in the non-aggressive behavior group, with statistically significant differences(P<0.05). Serum levels of T4, T3, and Cor in BD patients were negatively correlated with insight(r=-0.443, -0.364, -0.461, P<0.001). Serum T4(OR=1.192, 95%CI=1.052-1.352), T3(OR=1.177, 95%CI=1.036-1.337), Cor levels(OR=1.196, 95%CI=1.059-1.351), marital status(OR=1.175, 95%CI=1.010-1.366), and stress events(OR=1.183, 95%CI=1.043-1.341)were risk factors for aggressive behavior in BD patients, and ITAQ score(OR=0.781, 95%CI=0.663-0.921)was negatively correlated with the risk of aggressive behavior(P<0.05). The AUCs of serum T4 and Cor levels for predicting aggressive behavior were 0.755 and 0.725, respectively. Conclusion Serum levels of T4, T3, and Cor are negatively correlated with the insight of BD patients, and serum levels of T4 and Cor have certain predictive value for aggressive behavior in BD patients.

Key words: Bipolar disorder, Thyroxine, Triiodothyronine, Cortisol, Insight level, Aggressive behavior

CLC Number: 

  • R749.4
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