The Relationship Between Type A Personality And Thyroid-associated Ophthalmopathy

Backgrounds and ObjectivesThyroid associated ophthalmopathy which is one of the most common orbitaldisease, is a chronic autoimmune disease. Typical symptoms of the TAO include theupper eyelid retraction and lag，eyelid swelling and pain, monocular or binocularproptosis, restriction of ocular movement, diplopia, most associated with various degreesof abnormal thyroid function.The pathogenesis of thyroid associated ophathymopathy isnot clear at present.Treatment of thyroid associated ophthalmopathy such asglucocorticoids, strabismus surgery,orbital decompression operation,et al. are mostlywith traumatic or significant side effects.Patients with family history, female patientswere identified as risk factors for thyroid associated ophthalmopathy.Previous biologicalfactors play a major role in the pathogenesis of thyroid associated ophthalmopathy, butin recent years, due to the change of medical model, more and more people pay attentionto psychological factors in the occurrence and development effect of diseases.Type Apersonality is pressed for time urgency and competitive and hostility, while type Bpersonality’s relative lack of these two kinds of characteristics.Studies have shown thattype A personality than type B personality are more prone to hyperthyroidism, diabetes,coronary heart disease, psoriasis, central serous retinopathy, glaucoma.But therelationship between type A personality and thyroid-associated ophthalmopathy has notbeen reported at home and abroad.2.We using type A personality questionnaire in linewith China’s national conditions from the first edition―personality psychology‖whichfirst printed in August2012to test on thyroid associated ophthalmopathy primarypatients and the healthy volunteers, in order to preliminary investigate the relationshipbetween thyroid associated ophthalmopathy and the type A personality.MethodsFrom2013october to2014february in department of ophthalmopathy of theShanghai Changzheng Hospital outpatient and inpatient diagnosis of thyroid-associatedophthalmopathy whom the age is18years old to65years old primary patients andhealthy patients, A total of201selected patients were studied. Unified use the Type APersonality Questionnaire that from the"Psychology of personality"which the firstpublished and the first printed in2012August, in line with China’s national conditions tosurvey: when the Character integration (TH: time urgency+CH: competitive and hostility) is28to50, belongs to the type A personality, both the intermediate type whichis27points and lower than27were classified as to the type B personality, the polygraphquestions L entitled10points.Remove the81questionnaires that L greater than or equalto7, collected60cases of thyroid-associated ophthalmopathy patients and60healthycontrols to the study.Two groups of patients,a total of120cases, were1:1paired by age,culture level (high school and above). We adopt the marriage, sex (female), the familyhistory of thyroid-associated ophthalmopathy, and type A personality types as riskfactors.At first step,we compared the proportion of type A personality difference betweenthe two groups using chi square analysis,and than we conduct the case-control studyusing univariate and multivariate conditional Logistic regression.ResultsThe rate of thyroid associated ophthalmopathy group than in the healthy controlgroup of type A personality are increased significantly, the chi square value is5.829,P=0.013<0.05.The results of multi factor Logistic regression analysis of thyroidassociated ophthalmopathy and type A personality of showed that women, family historyof Graves disease is a risk factor for thyroid associated ophthalmopathy, according withthe literature,multivariate analysis showed that type A personality OR value was4.571(90%CI:1.912-10.926), the P value is0.0041, suggesting that the existence of the obviousrelationship between the type A behaviour personality and thyroid associatedophthalmopathy.Combined with the results of single factor analysis, the TH (time hurry:time is pressing type) factors have obvious influence on thyroid associatedophthalmopathy, the value of OR was1.126(95%CI:1.029-1.233).Type A behaviourpattern was shown to be an independent risk factor for the development of TAO.Conclusion○1The type A behavior personality can affect thyroid function and the correspondingplant nerve function and disorders of the immune system, increasing the chances ofhyperthyroidism and thyroid associated ophthalmopathy.The type A personality patientsshould pay attention to adjust their habits and emotions,such as efforts to overcomeanxiety and other adverse reaction of anger.We also need to analyze and correct the typeA behaviour personality, guide them to change their behavior consciously, so as to reducethe probability of thyroid associated ophthalmopathy disease and promote healing ofearly TAO patients, finally to the prevention and control of TAO disease progression andpromote rehabilitation effect. ○2Accordingtothethyroidassociatedophthalmopathyhascertainfamilialaggregation,we should prevent thyroid associated ophthalmopathy individualized, to family healtheducation unit, and promote individual TAO prevention work..The genetic backgroundpopulation and women with multiple stressors are the key control groups.○3The type Abehaviour personality is conducive to thyroid associated ophthalmologyprevention and rehabilitation. The type A personality, women and family history ofthyroid associated ophthalmopathy were risk factors for thyroid associatedophthalmopathy. The type A personality especially TH (time hurry) is an important riskfactor in the incidence of thyroid associated ophthalmopathy.People with type Apersonalities should be adjusted over time urgency, keeping a good mood is conducive tothyroid associated ophthalmology prevention and rehabilitation.