Approaching The Risk Factors Of Depression And Anxiety In Patients With Hyperthyroidism

Objective To study the risk factors of depression and anxiety in patients with hyperthyroidism. To compare the thyroid function, thyroid auto-antibodies and the status of emotion in the hyperthyroidism with depression and anxiety groups between pre-treatment and end of 4th and 8th week of treatment.Methods We collected 48 patients with hyperthyroidism and depression, 35 patients with hyperthyroidism and anxiety and 35 patients with hyperthyroidism and without depression and anxiety (as control group) aged 18⁶0 years old. We respectively collected the risk factors which probably influence hyperthyroidism complicating depression and anxiety, including gender, age, level of education, marriage state, profession, family history of thyroid disease, degree of goiter, heart rate, symptom of eye, and measured serum levels of total triiodothyronine (TT₃), total thyroxine (TT₄), free triiodothyronine (FT₃), free thyroxine (FT₄), thyroid-stimulating hormone (TSH), antithyroglobulin antibody (TGA) and antithyroidmicrosome antibody (TMA). Through case control study, then undertook statistical analysis to determine the risk factors influencing hyperthyroidism complicating depression and anxiety in these factors. Degree of goiter, heart rate and symptom of eye were examined, the serum levels of TT₃, TT₄, FT₃, FT₄, TSH, TGA and TMA were measured and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were evaluated at end of 4th and 8th week of treatment.Result There was statistical significant difference in the degree of goiter, heart rate and symptom of eye between the groups with hyperthyroidism complicating depression and anxiety and the control group (P< 0.01). The levels of serum TT₃, TT₄, FT₃, FT₄ and positive rate of TGA and TMA were higher (P <0 .01) and the levels of TSH were lower (P <0 .05) in the group with hyperthyroidism complicating depression than in the control group. The levels of serum TT₃, FT₃, FT₄ and positive rate of TMA were higher in the group with hyperthyroidism complicating anxiety than in the control group (P< 0.01). Logistic regression analysis showed that the symptom of eye, positive rate of TMA,FT₃ and FT₄ were the important risk factors in patients with hyperthyroidism and depression (OR=13.316, OR=7.830, OR=1.183, OR=1.089). Heart rate, degree of goiter, FT₃ and age were the important risk factors in patients with hyperthyroidism and anxiety (OR=8.715, OR=3.800, OR=1.241, OR=1.113). Thyroid function of patients with hyperthyroidism and depression was improved and heart rate was slower at end of 4th and 8th week of treatment and there was statistical significant difference compared with pre-treatment (P < 0.01). There was no statistical significant difference compared with pre-treatment in symptom of eye and positive rate of TGA and TMA of patients with hyperthyroidism and depression. Compared to the score of pre-treatment, HAMD and HAMA scores were no statistical difference in patients with hyperthyroidism and depression at end of 4th and 8th week. Thyroid function of patients with hyperthyroidism and anxiety was improved and heart rate was slower at end of 4th and 8th week of treatment (P < 0.01). Compared to score of pre-treatment, HAMA score was statistical difference in hyperthyroidism with anxiety group at end of 4th and 8th week (P < 0.01).Conclusions The symptom of eye, positive rate of TMA, FT₃ and FT₄ were the risk factors in patients with hyperthyroidism and depression. Heart rate, degree of goiter, FT₃ and age were the risk factors in patients with hyperthyroidism and anxiety. The depression and anxiety symptoms of patients with hyperthyroidism and depression had no marked change with thyroid function improving in short time.