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Review
. 2019 Oct 11:19:100207.
doi: 10.1016/j.jcte.2019.100207. eCollection 2020 Mar.

Graves' disease and mental disorders

Atsushi Fukao  1 , Junta Takamatsu  2 , Takeshi Arishima  3 , Mika Tanaka  4 , Toshio Kawai  5 , Yasuki Okamoto  6 , Akira Miyauchi  3 , Akihisa Imagawa  7
Affiliations
Review

Graves' disease and mental disorders

Atsushi Fukao et al. J Clin Transl Endocrinol. .

Abstract

Mental disorders merge highly with thyroid diseases. Because of its regulatory effects on serotonin and noradrenalin, T3 has been linked closely to depression and anxiety. It has known that in many cases, the mental symptoms persist even after normalization of thyroid function by treatment. Psychosocial factors including stress have been associated with mental symptoms even after thyroid function normalization in Graves' disease and a combination of mental disorders have been related to the exacerbation of hyperthyroidism. These findings suggest that psychosomatic approaches based on the bio-psycho-social medical model are important for the treatment of mental disorders associated with Graves' disease.

Keywords: Anxiety disorder; Depressive disorder; Eating disorder; Graves’ disease; Mental disorder; Stress.

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Figures

Fig. 1
Fig. 1
Comparison of the psychiatric outlook of “Basedow psychosis” between Mayo Clinic (1920–1931) and Ito hospital (1975–1979). Cited from reference .
Fig. 2
Fig. 2
Comparison of clinical scales of MMPI among the three groups of subjects. The data are shown as mean of T-scores in MMPI. T-scores (deviation scores) express the psychiatric tendency by each clinical scales. Table cited from reference was modified to figure. Hs (hypochondriasis), D (depression), Hy (conversion hysteria), Pd (psychopathic deviation), Mf (masculity and feminity), Pa (paranoia), Pt (psychastenia), Sc (schizophrenia), Ma (hypomania), Si (social introversion).
Fig. 3
Fig. 3
Changes in the depressive personality of Graves’ disease patients before and during treatment. Depressive personality patients show T-scores (deviation scores) for hypochondriasis, depression or psychasthenia greater than 60 points in the MMPI. GroupA: depressive personality was present before and persisted after treatment. GroupB: depressive personality scores became higher after treatment. GroupC: depressive personality was present before treatment and decreased to within the normal range after treatment GroupD: depressive personality did not appear either before or after treatment. Cited from reference .
Fig. 4
Fig. 4
Comparison of the prognosis of hyperthyroidism between the depression and non-depression groups. The data from each group are shown as mean ± SD. The gray zone expresses the normal range. Significant difference: *P < 0.05 using a Student t-test. Remission rate: depressive group 22% (5/23) vs non-depressive group 52% (13/25) (P < 0.05 using the chi-square test). Cited from reference .
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