Anxiety More Common Than Depression in Euthyroid Patients With Thyroid Disease

Although hypothyroidism is linked to depression, anxiety is the main complaint of euthyroid patients with thyroid disease, with or without Hashimoto thyroiditis.

Significantly more euthyroid patients with thyroid disease suffer from anxiety compared with depression, regardless of whether they have Hashimoto thyroiditis autoimmunity, according to research results presented at the American Association of Clinical Endocrinologists 28th Annual Scientific & Clinical Congress, held April 24 to 28 in Los Angeles, California.

Investigators used the Hospital Anxiety and Depression Scale/German version to gather self-reported data from 215 participants with thyroid disease (89% women; mean age, 46.8 ± 15.0 years). The scale comprises 7 anxiety-related and 7 depression-related items (scored 0-3). A score of ≥10 is indicative of anxiety or depression. The scale is validated to minimize somatic confounders.

Mean anxiety score was 6.78 ± 4.06 vs a depression score of 4.68 ± 4.11. The 70 patients (33%) with antibody-positive Hashimoto thyroiditis reported an anxiety score of 7.26 ± 4.23 and a depression score of 4.17 ± 4.15. Anxiety scores were significantly higher than depression scores (P =.0001), with no significant difference in respective severities.

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Analyses of patients with a score of ≥10 found 50 individuals (23%) with prominent anxiety scores (severity, 12.4 ± 2.4) and 22 patients (10%) with a prominent depression score (severity, 13.18 ± 3.6). In the group with Hashimoto thyroiditis, 18 participants (26%) had an average anxiety score of 12.6 ± 2.5, whereas 8 patients (11%) had an average depression score of 13.18 ± 3.6.

“Thyroid hormones are essential for nervous system development and alterations may lead to central nervous malfunctions, resulting in mood and cognitive disorders. Our findings indicate that anxiety might have a pathological pathway different from depressive disorders,” the investigators wrote. “Interdisciplinary collaboration is needed to evaluate cause-and-effect relationships and potential risk factors for development of psychosomatic cofactors in chronic somatic diseases.”

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Merke A, Merke J. Anxiety, not depression, is the most severe psychosomatic complaint in euthyroid patients with or without Hashimoto’s thyroiditis. Presented at: American Association of Clinical Endocrinologists 28th Annual Scientific & Clinical Congress; April 24-28; Los Angeles, CA.