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The Analysis of the Psychological Status and Related Factors in Patients with Hyperthyroidism

Author: GengHuiXia
Tutor: ZhaoDeShan；GaoGuiZhu
School: Shanxi Medical
Course: Medical Imaging and Nuclear Medicine
Keywords: hyperthyroidism symptom checklist 90 mental status radioiodine-131 treatment
CLC: R581.1
Type: Master's thesis
Year: 2010
Downloads: 298
Quote: 1
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Abstract

Objective The aims of this issue were to evaluate the psychological status and the main psychological problems of the patients with hyperthyroidism using Symptom Checklist 90 (SCL-90) questionnaire and to analyze the impact of related factors (including age, gender, medical history, drugs, exophthalmos, educational, thyroid weight) on the psychological problems, and the changes of mental status in the patients with hyperthyroidism before and after treatment with radioiodine-131. Methods There were 142 out-patients with hyperthyroidism recruited randomly in this study from April 2009 to August 2009 in the Department of Nuclear Medicine. All patients with hyperthyroidism were accordance with the diagnostic criteria of Graves disease within the textbook of internal medicine and had not other organic diseases and psychiatric history. The mental status of all patients were evaluated and followed up using Symptom Checklist90 by revised Wang Zhengyu and the thyroid function parameters of patients (for example, FT3, FT4 and sTSH) were acquired in 3 months after radioiodine-131 therapy. All data were analyzed by SPSS 11.0 statistical tool. T test was used in comparing between two groups.Results1. The all projects in SCL-90 questionnaire of the patients with hyperthyroidism were higher than those in normal people. The scores of the patients with hyperthyroidism were higher than that of normal in factors of somatization, obsessive-compulsive symptoms, depression, anxiety, hostility and psychotic. The order of major psychological problems in the patients with hyperthyroidism was hostility, depression= force, interpersonal, anxiety, somatization= paranoid psychosis, terror.2. The results was that the scores of female patients in the areas of depression and terror factors were higher than that of male patients, comparing SCL-90 scores between male and female patients with hyperthyroidism.3. Comparing SCL-90 scores between the patients in different age groups, we found that the scores of interpersonal, anxiety, hostility, mental factor were higher in the patients with below 35 years old(including 35 years of age) than the patients with over 35 years old.4. Comparing SCL-90 scores between the patients in different clinical history groups, the results showed that the scores of the body, interpersonal, depression, anxiety, hostility factors in the patients with more than or equal to 3 years history were higher than in the patients with less than three years history.5. The scores of depression, hostility, psychosis factors in the patients with ATD treatment were higher than in the patients without ATD treatment.6. All the factor scores were not significant difference between the patients with below junior middle school degrees and the patients with above junior middle school degrees.7. The scores of interpersonal sensitivity, anxiety, hostility, psychosis factors in the hyperthyroidism patients with more than or equal to 70g thyroid weight were higher than in the patient with less than 70g thyroid weight.8. The scores of anxiety, psychosis factors in the patients with thyrotoxic exophthalmos were higher than in the patients without exophthalmos.9. All the patients were divided into two groups:early-onset hypothyroidism-improved group(group I) and unchanged-deteriorated group(groupⅡ), based on the symptoms, signs of the patients and laboratory test(including FT3,FT4 and sTSH) in 3 months after therapy with radioiodine-131. There were 92 cases in group I and 14 patients in group II. The post-treatment total and every projects SCL-90 scores were less than that before treatment with radioiodine-131 in group I (p<0.05).The post-treatment total and some projects SCL-90 scores were less than that before treatment with radioiodine-131 in group II (p<0.05), in addition to obsessive-compulsive symptoms, hostility, terror, paranoia etc.Conclusions:1. The mental health status of the patients with hyperthyroidism was poorer than that of China normal people. The main psychological problems of the patients included hostility, depression = force, interpersonal, anxiety, somatization= psychotic paranoia, terror. The female patients with hyperthyroidism had more conspicuous psychological problems than the male patients. With up-aging, the psychological problems of the patients decreased. While the patients with hyperthyroidism had a long-lasting history, their psychological problems also increased. The psychological problems in the patients with ATD treatment were more than in the patients without ATD treatment. The mental status was no significant difference among the patients with different qualifications. The patients who had the more enlarged thyroid gland, namely, the more thyroid weight, had the more obvious psychological problems. The psychological problems were more significant in the patients with exophthalmos.2. With the remission of the patients’symptoms and signs, the psychological symptoms in the patients with hyperthyroidism were improved markedly in 3 months after treatment with radioiodine-131. It indicated that radioiodine 131 treatment was not only a fast, simple, economic, and safe method, and also can be able to quickly improve psychological status of the patients in the short term. Radioiodine 131 treatment will be a benefit to the restoration and improvement of the patients with hyperthyroidism.

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