Endocrine Abstracts

There is scant literature on various mental health parameters following treatment of hyperthyroidism. We present our initial results from an ongoing quality improvement project, jointly undertaken by the Endocrinology and Psychiatry teams.

Aim: To evaluate anxiety, depression, ability to work and quality of life (QOL) of patients with hyperthyroidism on presentation and after institution of specific therapy.

Method: We assessed 68 newly referred patients with overt hyperthyroidism with 4 Health Questionnaires; PHQ-9 for depression, GAD-7 for anxiety, EuroQoL for QOL and WSAS for functional impairment at baseline and 2 follow up visits at 3 and 6 months (mean 97 days and 192 days).

Result: 23% male, mean age 48.4±15.4 years. 23.5% had mild, 17.6% moderate and 26.5% severe anxiety pre-treatment, which decreased to 1.5%, 8.8% and 11.8% and to 4.4%, 1.5% and 1.5% at 3 and 6 months respectively. Depression scores were mild 16.2%, moderate 20.6%, moderately severe 19.1% and severe 13.2%, with post-treatment figures being 10.3%, 4.4%, 4.4% and 7.4% and 5.9%, 0%, 1.5% and 1.5% respectively. EQ5D vas score improved from baseline of 54.4±24.7 to 68.5±22.9 and 73.0±16.1 and WSAS scores from 7.4±11.0 to 6.3±9.0 and 1.1±3.8. The improvement was parallel to improvement in thyroid status. Only 8(11.8%) persons received psychotropic medications. Severity of hyperthyroidism was not an independent predictor of the degree of impairment of any parameter.

Conclusion: A significant proportion of patients had anxiety and depression, along with functional impairment and poorer quality of life at baseline. Following specific therapy for hyperthyroidism, all parameters improved in a majority of patients. Some patients continued to have impaired mental health and there was no formal management strategy for them. We recommend a formal assessment of mental health in patients with hyperthyroidism and an agreed strategy for its management when the improvement is delayed.