SUN-423 Impact of Hyperthyroidism and Its Treatment on the Outcome of Mental Health, Occupational Functioning and Quality of Life - a Prospective Study

Hyperthyroidism is known to be associated with psychiatric symptoms such as anxiety and depression, impartment of functioning and poor quality of life (QOL). It was intended to study the outcome of anxiety, depression, ability to work and QOL following the treatment of hyperthyroidism in endocrine clinic. In a prospective study, all newly referred hyperthyroidism patients with fully supressed TSH (<0.004 mIU/L) were followed up three monthly for more than a year. Besides the thyroid status and clinical assessment, they were assessed using Patient Health Questionnaire (PHQ)-9 for depression, Generalised Anxiety Disorder (GAD)-7 questionnaire for anxiety; EuroQoL (ED5D) for QOL and Work and Social Adjustment Scale (WSAS) to measure functional impairment. There were 177 participants (77.9% females), with a mean age of 50.1±15.6 years (range 16-86). Majority (88.7%) were having Grave’s disease and 11.3% had thyroid nodular disease; 10.2% had recurrent hyperthyroidism. At the baseline, anxiety was considered severe in 27.7%; similarly depression was moderately severe in 13.7% and severe in 14.9%. Although these decreased over time, considerable proportions continued to have these symptoms even after a year of treatment. A little over a quarter (26.6%) had beta-blockers at baseline and 9.0% had antidepressants; these proportions decreased reflecting symptomatic improvement. Proportions not-working changed from 28% to 18.2% within a year. WSAS suggested that the proportion with significant impairment changed from 46.7% to 34.6% (mean score change from 11.6 to 5.1). The EuroQoL mean score was 59.6 at the initial assessment which increased gradually to over 80. Most of these outcome parameters correlated with the improvement in thyroid status; however for many patients, mental health symptoms and functional impairments continued even after the thyroid tests became normal. Considerable proportion of patients with hyperthyroidism had anxiety, depression, functional impartment and poor quality of life; most of which improved with the course of anti-thyroid treatment; however a considerable proportion continued to have symptoms and impairments even after a year. This suggests the need for additional psychiatric intervention, probably early in the treatment to decrease the morbidity and improve QOL. Use of specific screening measures for psychiatric symptoms in the endocrinology clinics may be useful. References (1) Demet et al, Arch Med Res. 2002 Nov-Dec;33(6):552-6.