title: Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre.
abstract: OBJECTIVE
  Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.
  
  
  METHODS
  157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre completed the Hospital Anxiety and Depression Scale (HADS). The differences in the mean HADS scores between the groups were analysed using multiple linear regression, controlling for socio-demographic variables. HADS scores were also analysed dichotomized: a score >10 indicating probable 'anxiety'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression.
  
  
  RESULTS
  In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were associated with anxiety and depression symptoms.
  
  
  CONCLUSIONS
  Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity.
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Odense, Denmark.
authors.forename: Kira Bang
authors.initials: KB
authors.lastname: Bové
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Odense, Denmark ; Institute of Public Health, University of Copenhagen, Odense, Denmark.
authors.forename: Torquil
authors.initials: T
authors.lastname: Watt
authors.affiliation: Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Odense, Denmark.
authors.forename: Asmus
authors.initials: A
authors.lastname: Vogel
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hegedüs
authors.affiliation: Institute of Public Health, University of Copenhagen, Odense, Denmark ; National Research Centre for the Working Environment, Copenhagen, Odense University Hospital, Odense, Denmark.
authors.forename: Jakob Bue
authors.initials: JB
authors.lastname: Bjoerner
authors.affiliation: Institute of Public Health, University of Copenhagen, Odense, Denmark ; Department of Palliative Medicine, Bispebjerg Hospital, Odense, Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Groenvold
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
authors.forename: Steen Joop
authors.initials: SJ
authors.lastname: Bonnema
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Odense, Denmark.
authors.forename: Åse Krogh
authors.initials: ÅK
authors.lastname: Rasmussen
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Odense, Denmark.
authors.forename: Ulla
authors.initials: U
authors.lastname: Feldt-Rasmussen
keywords: Anxiety; Depression; Graves' disease; Nodular goitre; Quality of life