甲状腺结节患者的心理健康状况：一项横断面研究。
Mental Health Status of Patients with Thyroid Nodules: A Cross-Sectional Study.
作者信息
Wang Peng, Yan Jing, He Honghai, Che Ying
机构信息
Medical Examination Center, Peking University Third Hospital, Beijing, People's Republic of China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People's Republic of China.
出版信息
J Multidiscip Healthc. 2025 May 9;18:2641-2650. doi: 10.2147/JMDH.S513795. eCollection 2025.
PURPOSE
This study aims to investigate the mental health status of patients with high-risk and low-risk thyroid nodules (TNs), and the potential psychological risk factors that may exist in patients with high-risk nodules.
PATIENTS AND METHODS
In this cross-sectional study, a total of 7645 adults who participated in physical examinations from January 2021 to December 2023 were included. During the physical examination, they all completed thyroid ultrasound examinations and laboratory tests, and filled out self-administered questionnaires, as well as the Symptom Checklist-90 (SCL-90) and the Stress Self-Assessment Questionnaire-53 (SSQ-53). These were used to collect general information, mental health status, and stress levels of the subjects. According to the degree of malignant risk, TNs were categorized into high-risk groups (HRG) and low-risk groups (LRG). Differences between the two groups were compared in terms of general information, mental health status scores, and laboratory indicators.
RESULTS
The overall detection rate of TNs was 34.5%, with a significantly higher rate in women. There were significant differences in age and gender between HRG and LRG; The total score of SCL-90 in the HRG was significantly higher than that in LRG (128.78±45.65 vs 120.59±31.68, p=0.044); HRG exhibited a higher proportion of positive rates in the somatization (P=0.033) and anxiety (P=0.048) factors of the SCL-90. Among the 10 factors of SCL-90, the scores of somatization (P=0.011), obsessive-compulsive (P=0.010), interpersonal sensitivity (P=0.032), depression (P=0.036) and additional factors (diet and sleep) (P=0.008) in HRG were significantly higher. The results of SSQ-53 suggest that the overall stress level in HRG is higher, and the cognitive stress is significantly higher than that in LRG (P=0.003). Multivariate logistic regression analysis showed that age, gender, and SCL-90 total score were risk factors for high-risk TNs.
CONCLUSION
High-risk TNs are more common in females and older adults. The existence of high-risk TNs is related to poor mental health status.
目的
本研究旨在调查高危和低危甲状腺结节（TNs）患者的心理健康状况，以及高危结节患者可能存在的潜在心理危险因素。
患者与方法
在这项横断面研究中，纳入了2021年1月至2023年12月期间参加体检的7645名成年人。在体检期间，他们均完成了甲状腺超声检查和实验室检查，并填写了自填式问卷，以及症状自评量表90（SCL - 90）和压力自我评估问卷53（SSQ - 53）。这些用于收集受试者的一般信息、心理健康状况和压力水平。根据恶性风险程度，将TNs分为高危组（HRG）和低危组（LRG）。比较两组在一般信息、心理健康状况评分和实验室指标方面的差异。
结果
TNs的总体检出率为34.5%，女性检出率显著更高。HRG和LRG在年龄和性别上存在显著差异；HRG的SCL - 90总分显著高于LRG（128.78±45.65 vs 120.59±31.68，p = 0.044）；HRG在SCL - 90的躯体化（P = 0.033）和焦虑（P = 0.048）因子中的阳性率较高。在SCL - 90的10个因子中，HRG的躯体化（P = 0.011）、强迫（P = 0.010）、人际敏感（P = 0.032）、抑郁（P = 0.036）和附加因子（饮食和睡眠）（P = 0.008）得分显著更高。SSQ - 53的结果表明，HRG的总体压力水平较高，且认知压力显著高于LRG（P = 0.003）。多因素逻辑回归分析显示，年龄、性别和SCL - 90总分是高危TNs的危险因素。
结论
高危TNs在女性和老年人中更为常见。高危TNs的存在与心理健康状况不佳有关。
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