Effects of suppressive therapy of thyroid-stimulating hormone on emotion status in elderly patients

Abstract

Objective To analyze the effects of suppressive therapy of thyroid-stimulating hormone(TSH) on emotion status in elderly patients undergoing resection of differentiated thyroid cancer (DTC). Methods Serum levels of free T3 (FT3), free T4 (FT4) and TSH were measured in elderly patients. 165 patients were enrolled, in whom 74 cases with DTC underwent complete resection and TSH suppressive therapy 〔completely (CSG, n=33) and partially (PSG, n=41)〕, 43 cases with nodular goiter without TSH suppressive therapy (WSG) underwent bilateral subtotal thyroidectomy and 48 cases had normal thyroid function (normal control group, NCG). Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were used to evaluate patients' emotion status. Results There were significant differences in scores of HAMA between CSG and other three groups 〔PSG (P<0.05), WSG (P<0.01) and NCG (P<0.01)〕. However, there was no significant difference in HAMD scores among the four groups. Serum levels of TSH and FT4 were associated with the total scores of HAMA in CSG (both P<0.05). Conclusions The elderly patients in TSH completely suppressive group have more severe anxiety symptoms than the other groups, and their anxiety symptoms are correlated with thyroid dysfunction. The anxiety symptoms may be relieved by adjusting the TSH suppressive levels properly after DTC in elderly patients. Key words: Thyroid neoplasms; Thyrotropin; Anxiety; Emotional disorders