Endocrine Abstracts

Background: Primary hyperparathyroidism (PHPT) associates many psychiatric symptoms and is therefore important to find out if surgery can alleviates the psychiatric symptoms and improve the quality of patient’s life.

Objectives: To study the nature and severity of neuropsychiatric manifestations in patients diagnosed with hyperparathyroidism before and after surgery, as well as to evaluate the correlation of such symptoms with levels of serum calcium.

Methods: During this study we monitored the psychiatric symptoms occurrence and their correlation with serum calcium among 24 patients with primary hyperparathyroidism (group I), using a control group with 20 patients that were surgicaly treated with total thyroidectomy (group II). We assessed these patients using Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) before surgery and at 1, 8, 12 and 24 weeks after surgery.

Results: The PHTP patients had significantly higher levels of total serum calcium and PTH preoperatively, with biochemical normalization after surgery. The baseline BPRS score were higher in PHTP group, mean score 76.5, before surgery, compared to the control group with a mean score of 51.2. The CGI and GAF scores were also different between groups: 3.4 and 68.4 (group I before surgery), compared to 2.1 and 77.2 (group II). The improvement in neuropsychiatric symptoms was significant at 8 weeks after surgery as reflected in BPRS decreasing to 45.3, while CGI and GAF improved also, to 1.7 and 87.2. No correlation was found between the serum calcium levels and the psychiatric manifestations.

Conclusions: The PHTP associated psychopathology is very complex and symptoms significantly improved by 8 weeks post-parathyroidectomy. The evaluation of surgical interventions over the patients status is useful using clinical psychiatric rating scales but there was recorded no correlation of clinical mental status with serum calcium level.