Alci Deniz, Eroglu Mustafa, Asik Mehmet
Psychiatry, Balıkesir University, School of Medicine, Balıkesir, TUR.
Endocrinology, Diabetes, and Metabolism, Balıkesir University, School of Medicine, Balıkesir, TUR.
Cureus. 2025 Mar 31;17(3):e81503. doi: 10.7759/cureus.81503. eCollection 2025 Mar.
Introduction The relationship between thyroid hormone dysfunction and psychiatric symptoms is complex, with hyperthyroidism frequently presenting alongside mood and anxiety disorders. Temperament traits, enduring psychological characteristics, may significantly influence the clinical manifestation of depression and anxiety in hyperthyroid patients, yet they remain understudied. This study aimed to determine whether specific temperament traits in hyperthyroid individuals correlate with anxiety and depressive symptoms and explore their implications for personalized clinical management. Methods A total of 59 patients diagnosed with hyperthyroidism and 40 healthy controls participated in this study. All participants underwent clinical assessment, thyroid function testing (thyroid-stimulating hormone (TSH), T3, T4), and completed the Hospital Anxiety and Depression Scale (HADS) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Demographic and clinical parameters, including age, gender, body mass index (BMI), blood pressure, smoking status, and family history, were also documented. Statistical analyses included Mann-Whitney U tests for group comparisons, Spearman's correlation analysis for relationships between temperament traits and psychiatric symptoms, and generalized linear models (GLM) to identify predictors of depressive symptoms. Results Hyperthyroid patients exhibited significantly higher anxiety scores compared to controls (p<0.001), whereas depressive symptoms, although elevated, did not reach statistical significance (p>0.05). Temperament assessment revealed significantly increased depressive, cyclothymic, irritable, and anxious traits in patients compared to controls (p<0.001). Hyperthymic temperament showed no significant difference between groups. A notable positive correlation emerged between irritable temperament and increased depressive symptoms (r=0.635, p<0.001). Depressive temperament significantly predicted higher depression scores, while hyperthymic temperament appeared protective, associated with reduced depressive symptoms (p<0.05). Conclusions These findings highlight the importance of temperament traits as critical modulators of psychiatric outcomes in hyperthyroidism. Irritable and depressive temperaments may increase vulnerability to depressive disorders, whereas hyperthymic temperament could offer resilience. Integrating temperament assessment into clinical practice may enhance diagnostic precision and inform personalized therapeutic approaches, improving patient outcomes and quality of life.
引言 甲状腺激素功能障碍与精神症状之间的关系较为复杂，甲状腺功能亢进症常与情绪和焦虑症同时出现。气质特质，即持久的心理特征，可能会显著影响甲状腺功能亢进症患者抑郁和焦虑的临床表现，但这方面的研究仍较少。本研究旨在确定甲状腺功能亢进症患者的特定气质特质是否与焦虑和抑郁症状相关，并探讨其对个性化临床管理的意义。方法 共有59例诊断为甲状腺功能亢进症的患者和40名健康对照者参与了本研究。所有参与者均接受了临床评估、甲状腺功能测试（促甲状腺激素（TSH）、T3、T4），并完成了医院焦虑抑郁量表（HADS）和孟菲斯、比萨、巴黎和圣地亚哥气质自评问卷（TEMPS-A）。还记录了人口统计学和临床参数，包括年龄、性别、体重指数（BMI）、血压、吸烟状况和家族史。统计分析包括用于组间比较的曼-惠特尼U检验、用于气质特质与精神症状之间关系的斯皮尔曼相关分析，以及用于识别抑郁症状预测因素的广义线性模型（GLM）。结果 与对照组相比，甲状腺功能亢进症患者的焦虑得分显著更高（p<0.001），而抑郁症状虽然有所升高，但未达到统计学显著性（p>0.05）。气质评估显示，与对照组相比，患者的抑郁、环性心境、易怒和焦虑特质显著增加（p<0.001）。两组之间的轻躁狂气质没有显著差异。易怒气质与抑郁症状增加之间存在显著正相关（r=0.635，p<0.001）。抑郁气质显著预测更高的抑郁得分，而轻躁狂气质似乎具有保护作用，与抑郁症状减轻相关（p<0.05）。结论 这些发现凸显了气质特质作为甲状腺功能亢进症精神结局关键调节因素的重要性。易怒和抑郁气质可能会增加患抑郁症的易感性，而轻躁狂气质可能提供恢复力。将气质评估纳入临床实践可能会提高诊断准确性，并为个性化治疗方法提供依据，从而改善患者结局和生活质量。
