Röckel M, Teuber J, Schmidt R, Kaumeier S, Häfner H, Usadel K H
Klin Wochenschr. 1987 Mar 16;65(6):264-73. doi: 10.1007/BF01773447.
The study reported here was undertaken to establish the degree to which a person in a preclinical state of hyperthyroidism, with (by definition) euthyroid T3 and T4 levels but suppressed TRH on testing, already exhibits psychological changes and clinical symptoms. Two groups of 20 patients each, with clear clinical and preclinical hyperthyroidism (as defined by laboratory parameters), were studied, as well as a group of 20 controls. The subjects' psychological state of mind was investigated using self-rating scales, including the state-trait-anxiety inventory (STAI), "Befindlichkeits"-Skala (Bf-S'), depression scale (D-S'), and a list of adjectives (EWL-K) with 14 different aspects of affective moods. Cognitive achievements were evaluated using the d2 test. Subjects were examined for somatic symptoms in accordance with Crooks' index of hyperthyroidism. The results clearly showed that typical psychological and somatic changes are already present in preclinical hyperthyroidism, these changes being partly identical with those of definite hyperthyroidism. In both patient groups, a significant increase in anxiety, a sense of not feeling well, and emotional irritability were found, as well as a tendency towards depressiveness, and an increased lack of vitality and activity. Attentiveness and concentration in both patient groups were lower than in the control group. Both patient groups showed the same prevalence of symptoms, such as palpitations, preference of cold over heat, excessive sweating, nervousness, fine digital tremor, and increased heart rate. With regard to the results, the diagnosis "preclinical hyperthyroidism" thus gains importance. Further prospective studies are required to answer the question whether antithyroidal treatment will influence the described psychological and somatic state of patients with preclinical hyperthyroidism.
本研究旨在确定处于甲状腺功能亢进临床前期的人,其甲状腺激素T3和T4水平(根据定义)正常,但促甲状腺激素释放激素(TRH)检测结果被抑制,是否已经出现心理变化和临床症状。研究了两组各20例患者,一组为明确的临床甲亢患者,另一组为临床前期甲亢患者(根据实验室参数定义),并设立了一组20例对照。使用自评量表调查受试者的心理状态,包括状态-特质焦虑量表(STAI)、“情绪状态”量表(Bf-S')、抑郁量表(D-S')以及一份包含14种不同情感情绪方面的形容词列表(EWL-K)。使用d2测试评估认知成就。根据克鲁克斯甲亢指数检查受试者的躯体症状。结果清楚地表明,临床前期甲亢患者已经出现典型的心理和躯体变化,这些变化部分与明确甲亢患者的变化相同。在两组患者中,均发现焦虑、不适感、情绪易激惹显著增加,以及有抑郁倾向、活力和活动减少。两组患者的注意力和专注力均低于对照组。两组患者出现心悸、喜冷恶热、多汗、紧张、手指细微震颤和心率加快等症状的比例相同。鉴于这些结果,“临床前期甲亢”的诊断变得尤为重要。需要进一步的前瞻性研究来回答抗甲状腺治疗是否会影响临床前期甲亢患者上述心理和躯体状态的问题。