Psycho-endocrine disorders in adolescents with Graves’ disease

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Sh.T. Muratova


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.

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How to Cite
Muratova, S. “Psycho-Endocrine Disorders in Adolescents With Graves’ Disease”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 13, no. 4, July 2017, pp. 271-5, doi:10.22141/2224-0721.13.4.2017.106656.
Clinical Thyroidology


Antonova KV. Thyrotoxicosis. Changes of psyche. Possibilities of treatment. Rossijskij medicinskij zhurnal. 2006;14(13):14-5. (In Russian).

Balabolkin MI, Klebanova EM, Kreminskaja VM. Differencial'naja diagnostika i lechenie jendokrinnyh zabolevanij: Rukovodstvo [Differential diagnostics and treatment of endocrine diseases: Guidance]. Moscow: Medicina; 2002. 752 p. (In Russian).

Vorob'eva OV. Anxiety disorders in neurological practice. Rossijskij medicinskij zhurnal. 2007;24:18-20. (In Russian).

Grigor’eva EA, Pavlova EA. Depression and hyperthyroidism. Social’naja i klinicheskaja psihiatrija. 2010;2:100-7. (In Russian).

Muratova ShT, Ismailov SI. Influence of Graves’ disease on the psychocognitive state of children and adults (review of literature). Mіzhnarodnij nevrologichnij zhurnal. 2016;5(83):167-171. (In Ukraine). doi: 10.22141/2224-0713.5.83.2016.78483.

Fadeev VV. Thyroid diseases in regions of light iodine deficiency. Moscow: VIDAR; 2005. 240 p. (In Russian).

Citko EV, Korotaev AV, Naumenko EP, Kudlasevich SV. Features of the vegetative regulaation and structural-functional parameters of heart in diffusion toxic craw three months later after thyroidectomia. Problemy zdorov'ja i ekologii. 2013;2(36):70-5. (in Russian).

Aslan IR, Cheung CC. Early and late endocrine effects in pediatric central nervous system diseases. J Pediatr Rehabil Med. 2014;7(4):281-94. doi: 10.3233/PRM-140299.

Benseñor IM, Nunes MA, Diniz M de FS, Santos IS, Brunoni AR, Lotufo PA. Subclinical Thyroid Dysfunction and Psychiatric Disorders. Cross-Sectional Results From the Brazilian Study of Adult Health (ELSA-Brasil). Clin Endocrinol. 2016;84(2):250-6. doi: 10.1111/cen.12719.

Cao Y, Liu Z. Factor structure and factorial invariance of the State-Trait Anxiety Inventory for Chinese children and adolescents. Psych J. 2015;4(2):74-87. PMID: 26261907. doi: 10.1002/pchj.78.

Demet MM, Ozmen B, Deveci A, et al. Depression and anxiety in hyperthyroidism. Arch Med Res. 2002;33(6):552-6. PMID: 12505101.

Grabe HJ, Völzke H, Lüdermann J, et al. Mental and physical complaints in thyroid disorders in the general population. Acta Psychiatrica Scandinavica. 2005;112(4):286-93. doi: 10.1111/j.1600-0447.2005.00586.x.

Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63(11):467-72. PMID: 22588767. doi. 10.1002/acr.20561.

Muratova ShT, Ismailov SI. Mental characteristics of teenagers with Graves' disease in Uzbekistan. European science review (Vienna). 2015;7-8:77-9.

Orgilés M, Méndez X, Spence SH, Huedo-Medina TB, Espada JP. Spanish validation of the Spence Children's Anxiety Scale. Child Psychiatry Hum Dev. 2012;43(2):271-81. doi: 10.1007/s10578-011-0265-y.

Van Wijk CH. The use of Spielberger’s State-Trait Personality Inventory (trait anxiety subscale) with naval subaquatic specialists. Int J Occup Med Environ Health. 2014;27(6):959-66. doi: 10.2478/s13382-014-0321-5.