Psycho-endocrine disorders in adolescents with Graves’ disease

Abstract

Background. Thyroid dysfunction and mental disorders are common among the general population. In population studies, that thyrotoxicosis has been established to be accompanied by depression and anxiety. The purpose was to study the features of the psycho-emotional state in adolescents with Graves’ disease (GD). Materials and methods. Clinical and hormonal indices and features of the psycho-emotional state were studied in 19 adolescence with Graves’ disease using the Spielberg questionnaire (State Trait Personal Inventory, STPI) and the drawing test House-Tree-Man (HTM), proposed by J. Buk. The control group consisted of 12 healthy adolescents without thyroid pathology. Results. The average age of the examined adolescents with Graves’ disease was 13.0 ± 0.6 years; thyrotoxicosis was diagnosed 5.3 times more often in girls compared to boys. Endocrine orbitopathy was diagnosed in 68.4 % of adolescents with thyrotoxicosis. All the examined adolescents with GD had signs of the autonomic nervous system disorder. Also there were identified nonspecific symptoms such as: increased response to suddenness or fear (63.2 %), difficult concentra­ting or emptiness in the head due to worry or anxiety (47.4 %),
persistent irritability (94.7 %), difficult falling asleep due to anxiety (63.2 %). The results of the anxiety study by the STPI questionnaire revealed that among children with thyrotoxicosis the phenomena of anxiety and negative emotional experiences predominated (p < 0.05), but cognitive activity was lower (p < 0.05) when compared with those of the control group. While in a group of teenagers with toxic goiter, 100 % of children showed a high level of anxiety (range of scores of 24–40), in this group children with a high degree of negative emotional feelings (68.4 %) prevailed; and in the third of children (31.6 %) the average degree of negative emotional experiences was diagnosed. At the same time, in the control group 91.7 % of children had high cognitive activity, but among patients with thyrotoxicosis cognitive level had low activity in 10.5 % and moderate in 89.5 %. The results of the HTM test demonstrated that children with thyrotoxicosis had 2.1–6.4-fold increased indices of insecurity, anxiety, self-distrust, feeling of inferiority, hostility, proneness to conflict, difficulty in communication, depressiveness compared to the control group. Conclusions. Graves’ disease in adolescents has a pronounced effect on their psycho-emotional status and is manifested by anxiety disorder. It is ne­cessary to further study the emotional manifestations and anxiety syndrome in adolescents with Graves’ disease with a view to the integrated approach of endocrinologists and psychologists.