The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment.
The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment.
复制标题
DOI：
10.1186/1751-0759-5-9
复制
发表时间：
2011-08-09
影响因子：
2.1
通讯作者：
Hanafusa T
中科院分区：
文献类型：
--
作者：
Fukao A;Takamatsu J;Kubota S;Miyauchi A;Hanafusa T
我们之前报道过，接受长期抗甲状腺药物（ATD）治疗的格雷夫斯病（GD）患者的抑郁性人格（根据明尼苏达多相人格量表（MMPI）确定的忧郁症、抑郁和精神衰弱评分）和日常烦恼在复发组中显着高于缓解组，即使在甲状腺功能正常状态下也是如此。本研究旨在探讨初诊GD患者抑郁性格、情绪压力、甲状腺功能与甲亢预后之间的关系。 64 名未经治疗的 GD 患者在 ATD 治疗前和治疗期间对人格特征的 MMPI、针对重大生活事件的 Natsume 压力量表以及针对日常生活压力的 Hayashi 日常生活压力量表做出了反应。在未经治疗的甲状腺毒症状态下，44 名患者 (69%) 发现抑郁性人格（疑病症、抑郁症或精神衰弱的 T 分数大于 MMPI 60 分）。其中 15 名 (23%) 患者在治疗后评分降至正常范围。然而，其余 29 名患者（46%）在治疗后抑郁性格依然存在。 20名患者（31%）治疗前评分正常，15名患者（23%）评分持续正常。其余5名患者（8%）治疗后抑郁人格较高。这种抑郁的性格与甲状腺功能亢进的严重程度无关。治疗三年后，抑郁症组的血清 TSH 受体抗体活性显着高于非抑郁症组 (p = 0.0351)。抑郁症组治疗四年后的缓解率显着 (p = 0.0305) 低于非抑郁症组 (22% vs 52%)。数据表明，在接受ATD治疗的GD患者中，治疗期间的抑郁性格比甲状腺毒症更能反映情绪压力的影响，并且会加重甲亢。包括抗精神病药物和/或心理治疗在内的心身治疗方法似乎有助于改善甲状腺功能亢进症的预后。
We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI)) and daily hassles of Graves' disease (GD) patients treated long trem with antithyroid drug (ATD) were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI) were found for 44 patients (69%). For 15 (23%) of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%). Normal scores before treatment were found for 20 patients (31%), and the scores were persistently normal for 15 patients (23%). The remaining 5 patients (8%) had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351) greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305) lower in the depression group than in the non- depression group (22% vs 52%). The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of thyrotoxicosis and that it aggravates hyperthyroidism. Psychosomatic therapeutic approaches including antipsychiatric drugs and/or psychotherapy appears to be useful for improving the prognosis of hyperthyroidism.