Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur Thyroid J. 2023 Jul 12;12(4):e230040. doi: 10.1530/ETJ-23-0040.
Mental fatigue, depression, anxiety, and cognitive complaints are common in Graves' disease (GD). Our aims were to assess the relationship between these variables in patients with GD during both hyperthyroidism and a long stable euthyroidism.
A prospective longitudinal case-control study where 65 premenopausal women diagnosed with GD and 65 matched controls were assessed twice with 15 months in between. The first visit for patients was in overt hyperthyroidism and the second after treatment.
During the hyperthyroid phase, mental fatigue, depression, and anxiety were significantly increased for GD patients compared to controls (all P < 0.001). Among GD patients, 89% reported mental fatigue and among controls 14%. No difference in cognitive tests was found. After 15 months, significant improvements for GD patients after treatment were found for the items of mental fatigue, depression, and anxiety (all P < 0.001), but these were unchanged in controls. GD patients reported residual mental fatigue (38%), 23% without depression, and 15% mental fatigue combined with depression. Self-reported cognitive complaints were pronounced while cognitive tests did not reveal any deficiencies.
Mental fatigue and emotional distress are common in the hyperthyroid phase. These improve with treatment but are still more common in GD patients after 15 months of therapy than in controls. The residual mental fatigue is shown to be a phenomenon distinct from depression in this study. This indicates the importance of assessing mental fatigue in GD patients and underlines the need for rehabilitation and healthcare support as fatigue will have consequences for work ability.
精神疲劳、抑郁、焦虑和认知障碍在格雷夫斯病（GD）中很常见。我们的目的是评估 GD 患者在甲状腺功能亢进和长期稳定的甲状腺功能正常期间这些变量之间的关系。
这是一项前瞻性纵向病例对照研究，其中 65 名被诊断为 GD 的绝经前妇女和 65 名匹配的对照者在 15 个月的时间内进行了两次评估。患者的第一次就诊是在甲状腺功能亢进期，第二次就诊是在治疗后。
在甲状腺功能亢进期，与对照组相比，GD 患者的精神疲劳、抑郁和焦虑明显增加（均 P < 0.001）。GD 患者中有 89%报告有精神疲劳，而对照组为 14%。认知测试没有差异。15 个月后，治疗后的 GD 患者在精神疲劳、抑郁和焦虑项目上有显著改善（均 P < 0.001），但对照组无变化。GD 患者报告仍有精神疲劳（38%），23%无抑郁，15%精神疲劳伴抑郁。自我报告的认知障碍明显，而认知测试并未发现任何缺陷。
精神疲劳和情绪困扰在甲状腺功能亢进期很常见。这些在治疗后会改善，但在治疗 15 个月后，GD 患者仍比对照组更常见。本研究表明，残留的精神疲劳是一种与抑郁不同的现象。这表明在 GD 患者中评估精神疲劳的重要性，并强调了需要康复和医疗保健支持的必要性，因为疲劳会对工作能力产生影响。
