Mental Health Status and Factors that Influence the Course of Graves’ Disease and Antithyroid Treatments

D. Y. Chen; P. F. Schneider; X. S. Zhang; Z. M. He; J. Jing; T. H. Chen

doi:10.1055/s-0032-1323807

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2012; 120(09): 524-528
DOI: 10.1055/s-0032-1323807

Article

Mental Health Status and Factors that Influence the Course of Graves’ Disease and Antithyroid Treatments

D. Y. Chen

¹Department of Nuclear Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

,

P. F. Schneider

²Center of Internal Medicine, University Clinic, Clinic for Nuclear Medicine, Würzburg, Germany

,

X. S. Zhang

¹Department of Nuclear Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

,

Z. M. He

³Internal Medicine of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

,

J. Jing

⁴The School of Public Health, Sun Yat-sen University, Guangzhou, China

,

T. H. Chen

¹Department of Nuclear Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

› Author Affiliations

Abstract

Aims:

Biological, psychological and social factors may interact with the mental health status of Graves’ disease (GD) patients before and after antithyroid drug (ATD) treatment. Our aim was to quantify the impact of supportive and risk factors after recovery from GD which may enhance cure rates.

Patients and Methods:

300 patients were recruited for a 6-year prospective cohort study. Before and after treatment, we assessed the impact of biopsychosocial factors on the success of ATD treatment and mental health using the Symptom Checklist 90, the Eysenck Personality Questionnaire, the Life Event Scale, Simplified Coping Styles and the Perceived Social Support Scale. The patients routinely received ATD at least over 18 months. End-point was defined as cured (at least 2 years without a relapse after the withdrawal of ATD), otherwise as not cured.

Results:

Regression analysis explained 80.5% of the influences affecting mental health. The odds ratios (OR) revealed positive coping styles (OR: 2.90, 95% CI, 1.09–7.68), negative events (OR: 1.04, 95% CI, 1.01–1.07) and social support (OR: 5.10, 95% CI, 2.77–9.40) as protective factors, predicting a cure for GD patients. These variables explained 61.7% of the influences leading to a cure or no cure. Large thyroid volume was a risk factor, predicting failure (OR: 0.865, 95% CI, 0.83–0.90, P<0.000).

Conclusions:

Enhancing positive coping strategies and social support is important to improve mental health in GD patients, to avoid compromising work-related performance and endangering a patient’s social status.

Key words

thyroid autoimmunity - thyroiditis autoimmunity - thyrotropin hormones

Full Text

References

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