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.
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