Prevalence and Factors Associated with Hyperprolactinemia in Hospitalized Patients with Major Depressive Disorder

<title>Abstract</title> <p>Objective To investigate the prevalence of hyperprolactinemia (HPRL) and its associated factors in hospitalized patients with major depressive disorder (MDD), and to further analyze the factors associated with HPRL in the subgroup of patients not receiving antipsychotic medication. Methods This retrospective study included patients with MDD aged 18–60 years who had serum prolactin (PRL) measured during hospitalization at the Fourth People's Hospital of Chengdu between January 2022 and December 2023.Participants were categorized into the HPRL group and the normal PRL group. Multivariable logistic regression was used to identify independent correlates of HPRL in the overall MDD population and in the subgroup of patients not receiving antipsychotics. To control for potential confounding by age and sex, inverse probability of treatment weighting (IPTW) was employed as a sensitivity analysis in the overall population. Results A total of 1479 patients with MDD were enrolled, and the prevalence of HPRL was 37.3% (552/1479). Multivariable logistic regression revealed that risperidone (OR = 8.797, 95% CI: 3.792–20.407, P &lt; 0.001), olanzapine (OR = 2.570, 95% CI: 1.899–3.478, P &lt; 0.001༉, thyroid-stimulating hormone (OR = 1.075, 95% CI: 1.003–1.152, P = 0.004༉, and progesterone (OR = 1.014, 95% CI: 1.003–1.025, P = 0.009༉ were positively associated with HPRL. Aripiprazole (OR = 0.074, 95% CI: 0.032–0.173, P &lt; 0.001༉, quetiapine (OR = 0.622, 95% CI: 0.454–0.852, P = 0.003༉, repetitive transcranial magnetic stimulation (rTMS༉ treatment (OR = 0.642, 95% CI: 0.490–0.840, P = 0.001༉, age (OR = 0.968, 95% CI: 0.958–0.978, P &lt; 0.001༉, and free thyroxine ༈FT4༉ (OR = 0.917, 95% CI: 0.875–0.960, P &lt; 0.001༉ were negatively associated with HPRL. The trends of these associations remained consistent after IPTW weighting. In the subgroup of 451 MDD patients who did not receive antipsychotics, age (OR = 0.974, 95% CI: 0.957–0.991, P = 0.003༉ and rTMS treatment (OR = 0.570, 95% CI: 0.325–0.998, P = 0.049༉ were negatively associated with HPRL. Conclusion The prevalence of HPRL is relatively high among hospitalized patients with MDD. The type of antipsychotic medication is is the predominant influencing factor for HPRL. Additionally, age, rTMS treatment, and hormonal levels also affect the occurrence of HPRL. Further prospective studies are required to validate and supplement the current findings.</p>