Prä- und postoperative Lebensqualität, Angst und Depressivität beim primären Hyperparathyreoidismus im Vergleich zu einer Kontrollgruppe benigner Strumen - Ergebnisse einer prospektiven Multizenterstudie
Auch gedruckt in der BibliothekW: W-H 14.345
Ressourcen- / MedientypDissertation, Text
Datum der Freischaltung2015-09-10
Current guidelines recommend surgery as a curative option for symptomatic primary hyperparathyroidism (pHPT). A relevant number of pHPT patients, however, present non-specific symptoms e.g. fatigue, mood swings or depression, and are sometimes misclassified as “asymptomatic”. This prospective multicenter study investigated pre- and postoperative anxiety, depression and health-related quality of life (HRQOL) in pHPT patients and compared them to a control group with nontoxic thyroid nodules. Depression was evaluated with the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire (PHQ-9), which also assessed suicidal ideation. Anxiety was evaluated with the HADS. HRQOL was measured with the 36-item short form survey (SF-36). The study included 194 pHPT patients and 186 controls. Both groups were > 70% female; mean age was 58.5 (51.1) years for patients with pHPT (controls). Parathyroidectomy achieved a 98% cure rate. Preoperatively, moderate symptoms of depression (> 11- point HADS score) were seen in 20% (9%) of the pHPT group (controls). The PHQ-9 detected moderately to severe depression in 17% (7%) of pHPT patients (controls). pHPT patients showed higher HADS anxiety scores (mean 7.7) than did controls (p<0.01) or the German normative sample (p < 0.001). Compared to controls, pHPT patients had significantly lower SF-36 preoperative physical and mental health summary scores (42.7 vs. 49.5, 41.2 vs. 46.8, p = 0.001 for both comparisons) respectively. At 12 months´ follow-up, depression and anxiety decreased significantly in patients with pHPT; prevalence of suicidal ideation was more than halved from the baseline (10.7% vs. 22%, p =). Both physical and mental health scores (45.7, 47.7 respectively) improved in pHPT patients (p < 0.001, each), but not in controls. Depression, anxiety, and decreased HRQOL appear to be related to pHPT. Successful parathyroidectomy seems to reduce psychopathological symptoms and improve HRQOL in this setting.
LCSHQuality of life