title: Impaired health-related quality of life in Graves' disease. A prospective study.
abstract: OBJECTIVE
  In the acute, thyrotoxic phase, patients with Graves' disease often have both thyrotoxic and neuropsychiatric symptoms. The purpose of this prospective study was to examine health-related quality of life (HRQOL) in newly diagnosed and untreated Graves' patients and the effect of antithyroid medical treatment on HRQOL. In addition, we examined the potential influence of thyroid hormones and psychiatric symptoms on the impairment of HRQOL in the thyrotoxic phase.
  
  
  METHODS
  A total of 30 consecutively referred patients with newly diagnosed and untreated Graves' disease and 34 age-, sex- and education-matched healthy volunteers were included in the study. HRQOL was assessed with the Medical Outcome Study 36-item Short-Form Health Status Survey (SF-36) before treatment, after reaching euthyroidism and 1 year after initiation of treatment.
  
  
  RESULTS
  In the thyrotoxic phase of Graves' disease, HRQOL was significantly impaired, in physical, mental and social dimensions. After reaching euthyroidism, the patients reported much fewer limitations on the subscales of SF-36. One year after initiation of treatment, all SF-36 scores had normalized. However, in some patients, HRQOL continues to be impaired even 1 year after initiation of treatment, as reviewed by the individual analysis. The reduced HRQOL in the acute phase of Graves' disease was correlated to depressive and anxiety symptoms, but thyroid-associated orbitopathy also influenced HLQOL.
  
  
  CONCLUSIONS
  Impaired HRQOL is common in the acute phase of Graves' disease. A significant proportion of the patients demonstrated persistent HRQOL impairment 1 year after initiation of treatment. Improvement of HRQOL in these patients remains a challenge for the clinician.
authors.affiliation: Memory Disorders Research Unit, Neuroscience Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: T V
authors.initials: TV
authors.lastname: Elberling
authors.forename: A K
authors.initials: AK
authors.lastname: Rasmussen
authors.forename: U
authors.initials: U
authors.lastname: Feldt-Rasmussen
authors.forename: M
authors.initials: M
authors.lastname: Hørding
authors.forename: H
authors.initials: H
authors.lastname: Perrild
authors.forename: G
authors.initials: G
authors.lastname: Waldemar
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents