The Role Of Anger And Its Related Psychological And Physical Factors In Etiology Of Graves' Hyperthyroidism

Objective: This study was conducted to explore the role of anger and its relatedpsychological and physical factors in etiology of Graves' disease (GD).GD is one of theautoimmune thyroid diseases which are the most common organ-specific autoimmunedisorders with a greater incidence in women. Apart from the role of genes in the etiologyof GD, stress plays an important role in etiology of Graves' hyperthyroidism. Anger is oneof the most frequently experienced negative emotions. It is an important predictor of lifestress, and people with increased levels of anger are more likely to experience negative lifeevents. In terms of social outcomes, anger may be the most important of all negativeemotions. Anger expression is associated with human stress endpoints during daily life andin response to an ecologically valid stressor. In one study, the expression of outward andinward anger and the anger trait were all positively associated with the psychologicalimpact of a stressful mock captivity challenge. Anger has been related to heart disease,hypertension, cancer, cerebral infarction, and brain hemorrhage. If anger plays any role inetiology of GD? and if different components of anger play different role in etiology of GD?Few reports exist about these questions. We aimed to explore this association betweenanger, different components of anger and the etiology of GD.Methods:All participants (581patients and800normal controls) completed the StateTrait Anger Expression Inventory2(STAXI-2). Anger expression styles weredistinguished by Spielberger State-Trait Anger Expression Index-2(STAXI-2). Bodyconditions were evaluated by using Pittsburg Sleep Quality Index(PSQI) and FatigueAssessment Index(FAI). Eysenck Personality Questionnaire(EPQ). Basic characteristics ofall subjects were documented, Case-control and logistic regression analysis was used toexamine the association between anger and the etiology of GD. To examine the associationbetween Coping styles,Personalitites and the etiology of GD. To examine the associationbetween every component of anger and etiology of GD. Results:The anger trait and anger expression-in and anger-control were all associatedwith GD. For most patients, anger trait and anger expression-in both were adverse riskfactors of GD and anger control was a protective factor.The negative coping style (OR＝1.068, P＝0.000), concealing character(OR=1.121,P=0.000) and internal and external personality (OR=1.089,P=0.005)were adverse risk factors of GD(OR＝1.162,P＝0.000)." mental instability "and" poor subjective sleep quality "," sleeping long incubationperiod,"" poor function during the day,""discharging is not normal,"" fatigue and seriouspsychological consequences as a result of fatigue" were all risk factors of GD, while"habitual sleep efficiency "as a protective factor of GD.Most newly-diagnosed patients with GD often were companied with negativeemotions such as anger, depression, anxiety., After treatment depression,anxiety scoresboth decreased significantly; Anger Contro-In, Anger Contro-Out increased;5-HT, TSHincreased; DA,FT3,FT4declined.Conclusion—People with high anger traits and using to express anger-in should try tocontrol their anger by calming down and self-soothing to reduce the onset of GD.Endocrine physicians should focus on the psychological management of anger to preventand treat GD patients. Usually using positive coping style or changing internal and externalpersonality or changing concealing character can prevent effectively onset of GD. Fornewly diagnosed GD with anger, anxiety, depression,anti-thyroid drugs may be helpful fortheir disorder mood.For these patients,unless serious emotional disorders,drugs forregulating emotions are not needed.