Depression, Anxiety and Stress in Patients with Hyperthyroid Goiter and Patients with Euthyroid Benign Nodular Goiter

Abstract

Background: A higher incidence of depression, anxiety, and stress was found in patients with hyperthyroidism compared with the general population and patients with nontoxic nodular goiter. It is not clear whether the mental symptoms are related to increased levels of thyroid hormones or thyroid autoimmunity.

Methods: In a cross-sectional study, surgical candidates with hyperthyroidism or euthyroid benign nodular goiter completed a general questionnaire on sociodemographic data, comorbidities, and laboratory findings related to the thyroid disease and the Depression, Anxiety and Stress Scale questionnaire (DASS).

Main findings: Out of all the examined patients (n = 40), 85%, 65%, and 85% of them had depression, anxiety, and stress scores within the normal range. The euthyroid patients had significantly higher scores on the depression (p = 0.013) and stress (p = 0.005) subscales in comparison with the hyperthyroid patients. Compared with males, females had significantly higher scores on the depression (p = 0.046) and anxiety (p = 0.005) subscales. There was no significant relationship between the level of formal education and DASS subscale scores.

Principal conclusion: A small share of the surgical candidates examined for strumectomy had elevated levels of depression or stress. Compared with the hyperthyroid patients, the euthyroid patients showed higher levels of depression and stress. Females had higher levels of depression and anxiety in comparison with males. The levels of examined negative emotional states were not related to the formal education levels of patients.