Martino Gabriella, Caputo Andrea, Vicario Carmelo M, Feldt-Rasmussen Ulla, Watt Torquil, Quattropani Maria C, Benvenga Salvatore, Vita Roberto
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.
Front Psychol. 2021 May 11;12:667237. doi: 10.3389/fpsyg.2021.667237. eCollection 2021.
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 ( = -0.46, = 0.04). Besides, patients with seronegative HT had lower somatic anxiety than patients with HT who tested positive ( = -0.68, = 0.01 and = -0.59, = 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.
情绪加工障碍是躯体疾病发生的一个风险因素，对几种慢性病的健康相关生活质量（HRQoL）和疾病管理均产生负面影响。本初步研究旨在：（i）调查桥本甲状腺炎（HT）患者述情障碍与抑郁、焦虑及HRQoL之间的关联；（ii）检查HT患者中这三种心理状况与HRQoL、甲状腺自身抗体状态以及甲状腺回声质地之间的关联；（iii）比较HT患者与对照组所有这些临床心理特征的强度。本研究招募了21例血清学或超声检查确诊的HT患者以及16例患有非毒性甲状腺肿或术后甲状腺功能减退的对照者。检测了血清促甲状腺激素（TSH）、游离甲状腺素以及甲状腺自身抗体（甲状腺球蛋白抗体和甲状腺过氧化物酶抗体）。分别采用多伦多述情障碍量表、贝克抑郁量表第二版、汉密尔顿焦虑量表以及健康调查简表36评估述情障碍、抑郁、焦虑和HRQoL。发现描述情感的困难程度与抑郁的认知成分之间存在负相关（r = -0.46，P = 0.04）。此外，血清学阴性的HT患者的躯体焦虑低于检测阳性的HT患者（分别为r = -0.68，P = 0.01和r = -0.59，P = 0.04）。此外，HT患者与对照者在躯体焦虑方面未发现统计学显著差异。本研究提示述情障碍在HT患者中的相关性，其可能与一种可能未被充分报告的抑郁状态相互交织，这种抑郁主要通过身体不适表现出来。提高描述和表达情感的能力可能有助于心理调适和应对疾病，从而改善自我管理和感知的HRQoL。
