Endocrine Abstracts

Introduction: Reduction of quality of life in patients with chronic hypoparathyroidism (HPT) has been reported by several studies. Additionally, self-report data point to a higher prevalence of anxiety disorders in HPT compared to patients after thyroidectomy.

Objectives: To characterize psychiatric diseases in a systematically reviewed cohort of patients with chronic HPT.

Methods: We systematically assessed psychiatric comorbidities in a well--characterized cohort of patients with chronic HPT (n = 107) using standardized questionnaires (depression: Patient Health Questionnaire (PHQ9), Beck Depression Inventory (BDI2), anxiety: State-Trait Anxiety Inventory (STAI)) and further performed a diagnostic interview using the Mini-DIPS (n = 103).

Results: Out of the 103 interviewed patients 69% were female. 72% presented with postoperative HPT. The STAI provides a screening tool to assess both state (X1) and trait (X2) anxiety separately. Scores range from 20–80 with higher scores being positively correlated with higher levels of anxiety. In the STAI X1 21% of the patients scored between 40 and 50 and 25% of patients had a score above 50 (mean 40 ± 13). Regarding trait anxiety (STAI X2) 24% of patients had values between 40 and 50, whereas 20% scored above 50 points (mean 39 ± 12). In contrast, most patients with chronic HPT did not show markedly elevated scores in PHQ9 (81% with scores below 9), as well as BDI2 (72% with scores below 13). No significant correlations could be observed between serum calcium, parathyroid hormone or 25-OH-Vitamin D levels and scores of STAI X1, X2 and PHQ, whereas BDI2-scores significantly correlated with serum calcium levels (Pearson’s r = 0.386, P < 0.001). In the diagnostic interviews, anxiety disorder was found in 36% of patients. The kinds of anxiety disorders according to the Mini-DIPS were: Agoraphobia (31%), specific phobia (21%), panic syndrome (16%), generalized anxiety disorder (16%), social phobia (10%), and posttraumatic stress disorder (9%).

Conclusion: The performance of systematic screening as well as diagnostic interview for psychiatric disorders in HPT showed a high prevalence of anxiety disorders despite established treatment of HPT. However, the pathophysiology still remains unclear.