Abstract
Emotion-processing impairment represents a risk factor for the development of somatic illness, affecting negatively both health-related quality of life (HRQoL) and disease management in several chronic diseases. The present pilot study aims at (i) investigating the associations between alexithymia and depression, anxiety, and HRQoL in patients with Hashimoto’s thyroiditis (HT); (ii) examining the association between these three psychological conditions together with HRQoL, and thyroid autoantibodies status as well as thyroid echotexture in patients with HT; and (iii) comparing the intensity of all these clinical psychological features in patients with HT versus controls. Twenty-one patients with serologically or ultrasonographically verified HT and 16 controls with non-toxic goiter or postsurgical hypothyroidism were recruited for this study. Serum thyrotropin (TSH) and free thyroxine, as well as thyroid autoantibodies (thyroglobulin antibodies and thyroid peroxidase antibodies), were assayed. Alexithymia, depression, anxiety, and HRQoL were assessed with Toronto Alexithymia Scale; Beck Depression Inventory, second edition; Hamilton Anxiety Rating Scale; and Health Survey Short-Form 36, respectively. A negative relationship between the difficulty to describe feelings and the cognitive component of depression was found (r = -0.46, p = 0.04). Besides, patients with seronegative HT had lower somatic anxiety than patients with HT who tested positive (r = -0.68, p = 0.01 and r = -0.59, p = 0.04, respectively). Besides, no statistically significant difference was found between patients with HT and controls with regard to somatic anxiety. The present study suggests the relevance of alexithymia in patients suffering from HT, which may be intertwined with a possible state of underreported depression that is mainly expressed through physical complaints. Promoting the capability to describe and communicate feelings could contribute to psychological elaboration and coping with the disease and, consequently, to the improvement of self-management and perceived HRQoL.
Highlights
IntroductionIncreasing interest exists regarding the crucial role of psychological factors predicting somatic diseases and influencing the management of chronic illness (Caputo, 2014; Van Houtum et al, 2015; Catalano et al, 2017, 2018, 2019, 2020; Martino et al, 2018a,b, 2020c,d; Conversano, 2019; Kelly et al, 2019; Merlo, 2019; Lenzo et al, 2020; Conversano and Di Giuseppe, 2021)
Patients who were thyroidectomized for thyroid nodules, whose serum thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb) were both negative prior to surgery, and whose thyroid histology demonstrated benignity of the nodule and histological absence of lymphocytic thyroiditis were eligible as controls
Serum TSH and FT4 levels did not differ between patients with Hashimoto’s thyroiditis (HT) and controls (1.7 ± 1.0 vs. 1.5 ± 0.8 mU/L, P = 0.70; and 15.4 ± 3.9 vs. 15.4 ± 3.9 pmol/L, P = 0.96)
Summary
Increasing interest exists regarding the crucial role of psychological factors predicting somatic diseases and influencing the management of chronic illness (Caputo, 2014; Van Houtum et al, 2015; Catalano et al, 2017, 2018, 2019, 2020; Martino et al, 2018a,b, 2020c,d; Conversano, 2019; Kelly et al, 2019; Merlo, 2019; Lenzo et al, 2020; Conversano and Di Giuseppe, 2021). Chronic disorders pose relevant challenges to patients with specific regard to compliance and adherence, such as entrusting care relationships, taking medications properly, adjusting to new limitations, and changing lifestyle (Castelnuovo et al, 2015; Tomai et al, 2018; Rosa et al, 2019; Aimé et al, 2020; Gugliandolo et al, 2020) This overall requires a better handling of the psychosocial impact of chronic diseases and a paradigm shift in healthcare provision (Caputo, 2015; Van Houtum et al, 2015; Cicero et al, 2017; Conversano et al, 2020; Martino et al, 2020d). Negative emotional experiences in patients with metabolic syndrome and cardiovascular risk factors have been demonstrated (Bell et al, 2007; Goldbacher and Matthews, 2007)
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