1. Depression and Anxiety in Hyperthyroidism
- Author
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Sibel Boyvada, Mehmet Murat Demet, Ömer Aydemir, Hakan Adigüzel, Artuner Deveci, and Bilgin Özmen
- Subjects
Adult ,Male ,endocrine system ,medicine.medical_specialty ,Pediatrics ,endocrine system diseases ,Hamilton Anxiety Rating Scale ,Thyroid Gland ,Thyrotropin ,Anxiety ,Hospital Anxiety and Depression Scale ,Hyperthyroidism ,Antibodies ,Diagnosis, Differential ,Rating scale ,medicine ,Humans ,Euthyroid ,Psychiatry ,Depression (differential diagnoses) ,Ultrasonography ,Psychiatric Status Rating Scales ,Psychomotor retardation ,Depression ,business.industry ,Psychiatric assessment ,Age Factors ,General Medicine ,Middle Aged ,Thyroxine ,Case-Control Studies ,Triiodothyronine ,Female ,medicine.symptom ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients.Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features.Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p0.05); there was no difference in terms of HAD. When compared in terms of symptomatology, early insomnia (HAM-D#6), work and activities (HAM-D#7), psychic anxiety (HAM-D#10), weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group.Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation.
- Published
- 2002
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