Thyroid Research Thyroid Research Archive Hyperthyroidism

Some personality traits and daily hassles predispose patients with Graves' disease to recurrent hyperthyroidism

(July 2003)

The background of the study. This study was done to determine the importance of psychological factors in determining remission after antithyroid drug therapy in patients with hyperthyroidism caused by Graves' disease.

How the study was done. The study group consisted of 69 patients with Graves' hyperthyroidism treated with an antithyroid drug for two to five years. When therapy was stopped, the patients were evaluated using three questionnaires; the Minnesota Multiphasic Personality Inventory (Japanese version), a general stress inventory, and an inventory of stress in daily life. The patients then were followed for one year.

The results of the study. Forty-one of the 69 patients (59 percent) had recurrent hyperthyroidism and 28 patients (41 percent) remained euthyroid during the year of follow-up. When therapy was stopped, the mean serum free thyroxine concentration was the same in both groups, whereas the mean serum thyrotropin concentration was lower (0.8 vs. 1.9 mU/L) and thyroid volume was higher (44 vs. 23 ml) in the patients who later had recurrent hyperthyroidism.

The scores for hypochondriasis, depression, paranoia, and mental fatigue were higher in the patients who had recurrent hyperthyroidism, as compared with the patients who remained euthyroid. The frequency and total scores for major stressful life events, daily stressful events, and daily uplifts were not different in the two groups, but the score for daily hassles was higher in the patients who had recurrent hyperthyroidism.

The conclusions of the study. Patients with Graves' hyperthyroidism who have certain personality traits and more daily hassles are more likely to have recurrent hyperthyroidism after the cessation of antithyroid drug therapy than are those who remain well.

The original article. Fukao A, Takamatsu J, Murakami Y, Sakane S, Miyauchi A, Kuma K, Hayashi S, Hanafusa T. The relationship of psychological factors to the prognosis of hyperthyroidism in antithyroid drug-treated patients with Graves' disease. Clin Endocrinol 2003;58:550-5.