Endocrine Abstracts

Stressful condition and negative emotions can contribute to the overproduction of proinflammatory cytokines and promote immune dysregulation, which, in turn, increases the risk of various diseases, including autoimmune disorders. The present study was aimed at evaluating the relationship, if any, between psychological and individual characteristics (stress, coping and emotional intelligence) and thyroid autoimmunity.

Method

We enrolled 174 HT patients (gender: 157 female; 12 male; age: M = 47.01; S.D. = 13.36) and 133 euthyroid subjects (gender: 111 female, 21 male; aged M = 45.56; S.D. = 12.69) as controls. All subject had no personal and/or familial history of psychiatric disorders. All participants fell a set of psychological self-report questionnaires in order to measure psychological stress (MSP), coping strategy (Coping Inventory for Stressful Situations, CISS), trait emotional intelligence (TEIQue-SF) and Adverse Childhood Experiences (ACEs questioner).

Results

We found significant differences between patients and controls. MSP test showed greater levels of overall stress (P = 0.001) and stress subcategories, including psycho-physiologic sensations (P = 0.000), effort and confusion (P = 0.02), depressive anxiety (P = 0.01), pain and physical problems (P = 0.000), in HT patients than controls. Also, HT patients showed minor wellbeing (P = 0.020) and self-control (P = 0.047) compared to controls at TEIQue Test. Concerning coping strategies, HT patients seem to have more difficulties in adequately managing the emotional area (P = .004), which involves greater emotional responses, self-preoccupation, and a fantasizing tendency. Noteworthy, it emerged that HT patients have had a greater number of traumatic experiences in childhood (P = 0.01) than controls, with particular reference to physical abuse (P = .001), parental divorce (P = 0.02) and presence in the family of subjects suffering from mental illness (P = 0.05) or substance abuse (P = 0.38). The patha analysis on HT patients confirmed that the total stress is influenced by adverse childhood experiences (β = .12, P = .04) and by trait emotional intelligence (β = -.16, P = 0.02). It is conceivable that traumatic events occurring early in life might have had an influence on the subsequent development of autoimmune disease.

Conclusions

Our data suggest a correlation between psycho-social and immune factors. HT patients seem to have a very delicate psycho-affective equilibrium, difficulties in emotion regulation and impulse control, as well as in managing stress. Traumatic experiences in childhood and negative emotional responses may favor the subsequent development of autoimmunity, acting as an exogenous trigger in susceptible subjects. Autoimmunity, even in conditions of euthyroidism, can in turn negatively impact the psychological well-being of patients, who in fact appear less confident and optimistic.