Quality of life and occupational disability in endocrine orbitopathy

Abstract

Background: In endocrine orbitopathy (EO), disfiguring proptosis and diplopia impair patients' quality of life both at home and at work.

Methods: From late 2006 to the beginning of 2008, 250 outpatients in an interdisciplinary thyroid and eye clinic filled out a questionnaire about their quality of life, occupational disability, and use of psychotherapy. 400 physicians who referred their EO patients to the clinic also participated in a survey on these issues.

Results: 45% of the patients complained of restrictions in their daily activities, and 38% reported impaired self-perception. 36% were on sick leave because of EO. 28% were disabled, 5% had retired early, and 3% had lost their jobs. Patients with severe EO and motility disorders were on sick leave for longer times and were more likely to be disabled. 21% underwent psychotherapy. Patients who had been on sick leave for a long time and/or were disabled were more likely to undergo psychotherapy. Among the physicians answering the survey, 75% stated that they were taking care of temporarily disabled patients, while 34% were taking care of permanently disabled patients. 38% were treating EO patients who were undergoing psychotherapy.

Conclusions: These data indicate that patients with EO suffer considerable emotional stress and occupational impairment and point to the need for preventive care and rapid rehabilitation.

Keywords: Graves’ disease; endocrine orbitopathy; impaired earning capacity; occupational disability; quality of life.

Figure 1

a) Severity of endocrine orbitopathy depending on mean duration of occupational disability; p = 0.019, Kruskal-Wallis test b) Diplopia in patients with endocrine orbitopathy depending on mean duration of occupational disability; the association between occupational disability and diplopia score reaches significance; p = 0.008, Kruskal-Wallis test

Figure 2

a) Severity of endocrine orbitopathy depending on frequency of impaired earning capacity; p = 0.090, Kruskal-Wallis test b) Diplopia in patients with endocrine orbitopathy depending on frequency of impaired earning capacity; p<0.001, Kruskal-Wallis test

Figure 3

a) Mean duration of occupational disability in patients who were not receiving psychotherapy; p<0.001, chi-square test b) Mean duration of occupational disability in patients receiving psychotherapy; p<0.001, chi-square test

Figure 4

a) Frequency of impaired earning capacity in patients who were not receiving psychotherapy; P<0.001, chi-square test b) Frequency of impaired earning capacity in patients receiving psychotherapy; P<0.001, chi-square test