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自身免疫性甲状腺功能亢进症病程中的序贯心理测试。

Sequential psychological testing during the course of autoimmune hyperthyroidism.

作者信息

Paschke R, Harsch I, Schlote B, Vardarli I, Schaaf L, Kaumeier S, Teuber J, Usadel K H

机构信息

II. Medizinische Klinik, Klinikum Mannheim der Universität Heidelberg, Mannheim.

出版信息

Klin Wochenschr. 1990 Oct 3;68(19):942-50. doi: 10.1007/BF01646652.

Abstract

Although the psychological disturbances accompanying Graves' disease are well known, the time required for normalisation of these disturbances during antithyroid drug treatment is not known. Therefore sequential psychological testing during the course of Graves' disease was done. There are also contradictory results concerning the possible correlation of neurophysiological and psychological test results during the course of Graves' disease with thyroid hormone values. Finally, psychological disturbances have been proposed as possible etiologic factors in Graves' disease. In our study, a significant decrease in anxiety and irritability could be observed at the time euthyroidism was achieved. Self-evaluations of depressivity, activity, exhaustion, well-being, extraversion, introversion, and the ability to concentrate changed 1 or 2 months after euthyroidism was induced. Similar test results could be observed after induction of euthyroidism by antithyroid drugs and subtotal thyroid resection. Therefore the mode of therapy does not seem to influence the course of normalisation of psychological parameters. In contrast to other investigations there was hardly any correlation between thyroid hormone values and psychological test results or the ability to concentrate. Nontheless, patients with Graves' disease showing high scores for depression and anxiety exhibit abnormal peripheral helper/suppressor T-lymphocyte relations. Furthermore, patients suffering from Graves' disease tend to be more anxious than controls. It remains to be determined whether an increased susceptibility to psychological disturbances has led to these alterations of lymphocyte subsets in Graves' disease patients with severe depression and anxiety.

摘要

虽然格雷夫斯病伴发的心理障碍广为人知,但抗甲状腺药物治疗期间这些障碍恢复正常所需的时间尚不清楚。因此,我们对格雷夫斯病患者进行了连续的心理测试。关于格雷夫斯病病程中神经生理学和心理测试结果与甲状腺激素水平之间可能的相关性,也存在相互矛盾的结果。最后,心理障碍被认为可能是格雷夫斯病的病因。在我们的研究中,甲状腺功能正常时可观察到焦虑和易怒情绪显著降低。在甲状腺功能正常诱导1或2个月后,抑郁、活动、疲惫、幸福感、外向性、内向性以及注意力集中能力的自我评价发生了变化。通过抗甲状腺药物和甲状腺次全切除诱导甲状腺功能正常后,可观察到类似的测试结果。因此,治疗方式似乎并不影响心理参数恢复正常的过程。与其他研究不同,甲状腺激素水平与心理测试结果或注意力集中能力之间几乎没有相关性。尽管如此,格雷夫斯病患者中抑郁和焦虑得分较高者外周辅助/抑制性T淋巴细胞关系异常。此外,格雷夫斯病患者往往比对照组更焦虑。对于患有严重抑郁和焦虑的格雷夫斯病患者,心理障碍易感性增加是否导致了这些淋巴细胞亚群的改变,仍有待确定。

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