Alexithymia and anxiety-depressive disorders in patients with controlled and newly diagnosed manifest hypothyroidism

• Inna V. Druk
• Farida K. Urazova
• Olga V. Nasekina
• Kseniya A. Agisheva

Abstract

Aim: to analyze alexithymia and anxiety-depressive disorders in patients with controlled and newly diagnosed manifest hypothyroidism.

Material and methods. An open-label comparative study involving 111 patients with hypothyroidism, who were divided into 2 groups: patients with newly diagnosed manifest hypothyroidism (group 1) (n=12) and patients with drug-controlled hypothyroidism (group 2) (n=99). The groups were comparable in terms of sex, age, body mass index, etiology of hypothyroidism, and comorbidities. Alexithymia was identified using the Toronto Alexithymia Scale (TCA), and anxiety and depression were identified using the Hospital Anxiety and Depression Scale (HADS). Clinical status analysis was carried out in the general group of patients (n=111), in groups 1 and 2.

Results. In the general group of patients, alexithymic personality profile was detected in 49 patients (44.14%), anxiety and/or depression were determined in 64 patients (57.66%). Patients with alexithymia in the general group had a higher number of complaints compared to patients without alexithymia – 10 (8; 12) and 7 (4; 11; p=0.002), respectively. Also, a higher number of complaints in the general group was typical for patients with symptoms of anxiety and depression (n=66) compared to patients without these symptoms – 9 (7.25; 12) and 5 (3; 10; p=0.001), respectively. There was a direct moderate correlation between the TAS score and the HADS score (p<0.05). Analysis of groups 1 and 2 showed that patients in group 1 had a higher number of complaints: 12 (9; 14) and 8 (5; 11), respectively, in groups 1 and 2 (p<0.05). The alexithymic personality type was equally common in both groups (66.66% in group 1, 41.41% in group 2, p>0.05). In both groups, patients with alexithymia presented a significantly higher number of complaints (p<0.05). More than half of the patients in group 1 and group 2 had manifestations of anxiety and/or depression according to HADS, no differences between the groups were found (p>0.05). In both groups, positive correlations were found between the number of complaints and the score on the anxiety scale (p<0.05) and between the number of complaints and the TAS score (p<0.05).

Conclusion. The psychological status of patients is characterized by a high prevalence of alexithymia, anxiety and/or depression with no differences between groups 1 and 2. Group 2 patients, despite the compensation of hypothyroidism and the absence of concomitant pathology in most cases, continue to present some complaints. Patients with alexithymia and a high score on the anxiety scale, with uncontrolled (group 1) and controlled hypothyroidism (group 2) present a significantly higher number of complaints. Thus, the subjective status of patients in these groups is characterized by a variety of non-specific complaints and is formed in some patients under the influence of the peculiarities of their psychological status (alexithymia, high level of anxiety). Studies in the group of patients with hypothyroidism who persist in certain complaints against the background of reaching the target TSH level should be continued, assuming the heterogeneity of the causes of such a clinical situation. Identification of the features of the psychological status of patients and their correction can be clinically important for improving the quality of life and treatment satisfaction in patients with hypothyroidism.

Keywords:hypothyroidism; alexithymia; anxiety; depression

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