Abstract
Objectives: We examined the relationships among physical complaints, health-related quality of life (HRQL), anxiety and depression in differentiated thyroid cancer (DTC) patients under short-term hypothyroidism. Methods: We conducted a cross-sectional study in 136 patients hypothyroid on thyroid hormone withdrawal (THW) hospitalized for radioiodine administration. Patients were assessed using Short Form SF-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Beck Depression Inventory (BDI), and physical complaints. Results: Compared to the German general population, hypothyroid patients had significantly impaired HRQL. Surprisingly, the prevalence of anxiety (62.5%), but not depression (17.9%) was much higher in hypothyroid DTC patients than in the general population. In multivariate analysis, depression and age were independently associated with the physical health score (R 2 = 0.21), but only psychological variables (depression, mood disturbance, and anxiety) were associated with the mental health score (R 2 = 0.43), on the SF-36 HRQL instrument. Conclusions: HRQL is severely impaired in DTC patients under short-term hypothyroidism. As potential predictors of generic HRQL impairment, depression, anxiety, and mood disturbance could be used to preselect the patients most needing psychiatric care. The high frequency of anxiety should be considered in the aftercare of thyroid cancer patients.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
N Aass SD Fossa AA Dahl TJ Moe (1997) ArticleTitlePrevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital Eur J Cancer 33 1597–1604 Occurrence Handle10.1016/S0959-8049(97)00054-3 Occurrence Handle1:STN:280:DyaK1c%2FltFelsg%3D%3D Occurrence Handle9389921
S Broers A Kaptein S LeCessie W Fibbe MW Hengeveld (2000) ArticleTitlePsychological functioning and quality of life following bone marrow transplantation: A 3-year follow-up study J Psychosom Res 48 11–21 Occurrence Handle10.1016/S0022-3999(99)00059-8 Occurrence Handle1:STN:280:DC%2BD3c3ht1KlsQ%3D%3D Occurrence Handle10750625
S Sellick D Crooks (1999) ArticleTitleDepression and cancer: An appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions Psycho-Oncology 8 315–333 Occurrence Handle10.1002/(SICI)1099-1611(199907/08)8:4<315::AID-PON391>3.0.CO;2-G Occurrence Handle1:STN:280:DyaK1MvgsVSqug%3D%3D Occurrence Handle10474850
J Skarstein N Aass S Fossa E Skovlund A Dahl (2000) ArticleTitleAnxiety and depression in cancer patients: Relation between the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire J Psychosom Res 49 27–34 Occurrence Handle10.1016/S0022-3999(00)00080-5 Occurrence Handle1:STN:280:DC%2BD3M7kslOjuw%3D%3D Occurrence Handle11053601
H Zulewski B Müller P Exer AR Miserez JJ Staub (1997) ArticleTitleEstimation of tissue hypothyroidism by a new clinical score: Evaluation of patients with various grades of hypothyroidism and controls J Clin Endocrinol Metab 82 771–776 Occurrence Handle10.1210/jc.82.3.771 Occurrence Handle1:STN:280:ByiB3Mnit1c%3D Occurrence Handle9062480
El Constant AG Volder ParticleDe A Ivanoiu et al. (2001) ArticleTitleCerebral blood flow and glucose metabolism in hypothyroidism: A positron emission tomography study J Clin Endocrinol Metab 86 3864–3870 Occurrence Handle10.1210/jc.86.8.3864 Occurrence Handle1:CAS:528:DC%2BD3MXlvFeku7g%3D Occurrence Handle11502825
PW Ladenson LE Braverman EL Mazzaferri et al. (1997) ArticleTitleComparison of administration of recombinant human thyrotropin with withdrawal of thyroid hormone for radioactive iodine scanning in patients with thyroid carcinoma N Engl J Med 337 888–896 Occurrence Handle10.1056/NEJM199709253371304 Occurrence Handle1:CAS:528:DyaK2sXmtlylurY%3D Occurrence Handle9302303
CA Meier LE Braverman SA Ebner et al. (1994) ArticleTitleDiagnostic use of recombinant human thyrotropin in patients with thyroid carcinoma (Phase I/II Study) J Clin Endocrinol Metab 78 188–196 Occurrence Handle10.1210/jc.78.1.188 Occurrence Handle1:STN:280:ByuC3MjmtFc%3D Occurrence Handle8288703
KH Dow BR Ferrell C Anello (1997a) ArticleTitleQuality-of-life changes in patients with thyroid cancer after withdrawal of thyroid hormone therapy Thyroid 7 613–619 Occurrence Handle1:STN:280:ByiH3sfks1c%3D
K Dow B Ferrell C Anello (1997b) ArticleTitleBalancing demands of cancer surveillance among survivors of thyroid cancer Cancer Practice 5 289–294 Occurrence Handle1:STN:280:DyaK1c%2FgtVCqtQ%3D%3D
KI Stajduhar J Neithercut E Chu et al. (2000) ArticleTitleThyroid cancer: patients’ experiences of receiving iodine-131 therapy Oncol Nurs Forum 27 1213–1218 Occurrence Handle1:STN:280:DC%2BD3cvmt1yksA%3D%3D Occurrence Handle11013902
BR Haugen F Pacini C Reiners et al. (1999) ArticleTitleA comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer J Clin Endocrinol Metab 84 3877–3885 Occurrence Handle10.1210/jc.84.11.3877 Occurrence Handle1:CAS:528:DyaK1MXntlOqt74%3D Occurrence Handle10566623
M Sant T Aareleid F Berrino et al. (2003) ArticleTitleSurvival of cancer patients diagnosed 1990–1994 – results and commentary Ann Oncol 14 V61–V118 Occurrence Handle10.1093/annonc/mdg754 Occurrence Handle14684501
M Schlumberger (1999) ArticleTitleDiagnostic follow up of well-differentiated thyroid carcinoma: historical perspective and current status J Endocrinol Invest 22 3–7 Occurrence Handle1:STN:280:DC%2BD3c7ovFGgsQ%3D%3D Occurrence Handle10726999
O Cohen S Dabhi A Karasik S Zila Zwas (2004) ArticleTitleCompliance with follow-up and the informative value of diagnostic whole-body scan in patients with differentiated thyroid carcinoma given recombinant human TSH Eur J Endocinol 150 285–290 Occurrence Handle10.1530/eje.0.1500285 Occurrence Handle1:CAS:528:DC%2BD2cXivFCktro%3D
JE Ware KK Snow M Korinski B Gandeck (1993) SF-36 Health Survey manual and interpretation guide New England Medical Center, The Health Institute Boston
M Bullinger I Kirschberger JE Ware (1995) ArticleTitleThe German SF-36 Health Survey Z Gesundheitswissenschaft 10 21–36
M Bullinger I Kirschberger (1998) SF-36 Fragebogen zum Gesundheitszustand Göttingen Hogrefe
AS Zigmond RP Snaith (1983) ArticleTitleThe Hospital Anxiety and Depression Scale Acta Psychiatr Scand 67 361–370 Occurrence Handle1:STN:280:BiyB2sbhtVw%3D Occurrence Handle6880820
AT Beck CH Ward M Mendelson JE Mock JK Erbaugh (1961) ArticleTitleAn Inventory for measuring depression Arch Gen Psychiatry 4 561–571 Occurrence Handle1:STN:280:CC%2BD3cjmtFQ%3D Occurrence Handle13688369
DM McNair M Lorr LF Droppeleman (1971) EITS Manual for the Profile of Mood States Educational and Industrial Testing Service San Diego CA
CC Gotoy JD Stern (1995) ArticleTitleAssessment of psychological functioning in cancer-patients J Psychosoc Oncol 13 123–160 Occurrence Handle10.1300/J077V13N01_08
WZ Billewicz RS Chapman J Crooks et al. (1969) ArticleTitleStatistical methods applied to the diagnosis of hypothyroidism Q J Med 150 255–266
R Görges (2001) The changing epidemiology of thyroid cancer HJ Biersack F Grünwald (Eds) Thyroid Cancer Springer Heidelberg
JI Botella-Carretero JM Galán C Caballero J Sanco HF Escobar-Morreale (2004) ArticleTitleQuality of life and psychometric functionality in patients with differentiated thyroid carcinoma Endocrine-Related Cancer 10 601–610 Occurrence Handle10.1677/erc.0.0100601
R Crevenna G Zettinig M Keilani et al. (2004) ArticleTitleQuality of life in patients with non-metastatic differentiated thyroid cancer under thyroxine supplementation therapy Support Care Cancer 11 597–603 Occurrence Handle10.1007/s00520-003-0474-4
DF Tate BB Riley R Perna S Roler (1997) ArticleTitleQuality of life issues among women with physical disabilities or breast cancer Arch Phys Med Rehabil 78 18–25 Occurrence Handle10.1016/S0003-9993(97)90217-3
M Bullinger (1995) ArticleTitleGerman translation and psychometric testing of the SF-36 Health Survey: Preliminary results from the IQOLA Project Soc Sci Med 41 1359–1366 Occurrence Handle10.1016/0277-9536(95)00115-N Occurrence Handle1:STN:280:BymC3s7otlU%3D Occurrence Handle8560303
L Liu K Meers A Capurso T Engebretson A Glicksman (1998) ArticleTitleThe impact of radiation therapy on quality of life in patients with cancer Cancer Practice 6 237–242 Occurrence Handle10.1046/j.1523-5394.1998.006004237.x Occurrence Handle1:STN:280:DyaK1cvktVensg%3D%3D Occurrence Handle9767337
EJ Sachar (1995) Psychiatric disturbances associated with endocrine disorders DX Freedman JE Dyrud (Eds) American Handbook of Psychiatry NumberInSeriesVol. 4 Basic Books New York 299–313
EJ Maher C Mackenzie T Young D Marks (1996) ArticleTitleThe use of the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-C30 questionnaire to screen for treatable unmet needs in patients attending routinely for radiotherapy Cancer Treat Rev 22 123–129 Occurrence Handle10.1016/S0305-7372(96)90074-2 Occurrence Handle8625337
SD Fossa AA Dahl (2002) ArticleTitleShort Form 36 and Hospital Anxiety and Depression Scale – a comparison based on patients with testicular cancer J Psychosom Res 52 79–87 Occurrence Handle10.1016/S0022-3999(01)00308-7 Occurrence Handle1:STN:280:DC%2BD387ltlSisw%3D%3D Occurrence Handle11832253
AT Dugbartey (1998) ArticleTitleNeurocognitive aspects of hypothyroidism Arch Intern Med 158 1413–1418 Occurrence Handle10.1001/archinte.158.13.1413 Occurrence Handle1:STN:280:DyaK1czivVartA%3D%3D Occurrence Handle9665349
R Larisch K Kley S Nikolaus et al. (2004) ArticleTitleDepression and anxiety in different function states Horm Metab Res 36 650–653 Occurrence Handle10.1055/s-2004-825925 Occurrence Handle1:CAS:528:DC%2BD2cXptlGisbs%3D Occurrence Handle15486818
DA Fischer (1996) ArticleTitlePhysiological variations in thyroid hormones: Physiological and pathophysiological considerations Clin Chem 42 135–139
B Hirsberg JD Veldhuis NJ Sarlis (2000) ArticleTitleDiurnal thyrotropin secretion in short-term profound primary hypothyroidism: Does it ever persist? Thyroid 10 1101–1106 Occurrence Handle10.1089/thy.2000.10.1101
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tagay, S., Herpertz, S., Langkafel, M. et al. Health-related Quality of Life, Depression and Anxiety in Thyroid Cancer Patients. Qual Life Res 15, 695–703 (2006). https://doi.org/10.1007/s11136-005-3689-7
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s11136-005-3689-7