[Chronic distress syndrome in patients with Graves' disease].
OBJECTIVE
Cross-sectional study to evaluate the psychological distress of patients with Graves' disease 5 years after diagnosis.


METHODS
45 female patients being treated for Graves' disease in a specialized endocrinological practice in Wuppertal, Germany, were asked to fill in the Symptom Checklist-90-R (SCL-90-R) and the Hospital Anxiety and Depression Scale (HADS). All patients were in a euthyroid state for at least 6 months.


RESULTS
Patients were found to have significantly elevated mean values in the SCL-90-R compared with normal values for healthy test candidates. According to the Global Severity Index (GSI) more than one third (35.6%) of patients were suffering from psychological distress. These patients also showed elevated scores in the anxiety subscale of HADS. Almost all patients (95.6%) had elevated scores in the depression subscale of HADS. Patients with high levels of psychological distress (GSI > 60) were more likely to suffer a relapse than those with normal levels (p < 0.05). Patients in latent hyperthyroid state did not show higher levels of psychological distress than those with normal thyrotropin (TSH).


CONCLUSIONS
Many patients with a history of Graves' disease suffer from chronic psychological distress which cannot be explained by the metabolic state of the thyroid gland. Whether this finding results from damage to the CNS or reflects a generally increased stress vulnerability is unclear. Psychological treatment appears to be indicated in many cases of Graves' disease.
Abteilung für klinische Forschung, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany. cscheffer@web.de
Christian
C
Scheffer
Christian
C
Heckmann
Tatjana
T
Mijic
Karl-Heinz
KH
Rudorff
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires