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Hyperthyroidism

from Medical topics

Published online by Cambridge University Press:  18 December 2014

By
Nicoletta Sonino  and
Giovanni A. Fava
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Nicoletta Sonino
Affiliation:
University of Padova
Giovanni A. Fava
Affiliation:
University of Bologna
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

The term ‘hyperthyroidism’ refers to disorders which result from overproduction of hormone by the thyroid gland. The term ‘thyrotoxicosis’ is broader and denotes the clinical, physiological and biochemical findings that occur when the tissues are exposed to, and respond to excess thyroid hormone, thyroxine (T4) and triiodothyroxine (T3), not necessarily originating from the thyroid gland. Common symptoms include nervousness, sleep disturbances, tremors, frequent bowel movements, excessive sweating and heat intolerance. Weight loss is usual despite a normal appetite and food intake. Graves' disease, also known as Basedow's disease, is the most common form of hyperthyroidism in patients younger than 40 years. It is a disorder which has a complex pathogenesis (with involvement of autoimmune factors) and is characterized by these major manifestations: thyrotoxicosis associated with diffuse goitre, ophthalmopathy and dermopathy. Other relatively common forms include toxic adenoma, toxic multinodular goitre and subacute thyroiditis.

A large body of literature on psychosocial aspects of hypherthyroidism is available

Life events

The notion that stressful life events may be followed by hyperthyroidism has been a common clinical observation. Bram (1927) reviewed 3343 cases of exophthalmic goitre. In 85% of cases he detected ‘a clear history of psychic traumas as the exciting cause of the disease’. Several retrospective controlled studies (Winsa et al., 1991; Sonino et al., 1993a; Kung, 1995; Radosavljevic et al., 1996; Yoshihuchi et al., 1998; Matos-Santos et al., 2001) have substantiated these clinical observations. All these studies used valid and reliable methods for life events collection.

Type
Chapter
Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 745 - 746
Publisher: Cambridge University Press
Print publication year: 2007

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References

Bram, I. (1927). Psychic traumas in pathogenesis of exophthalmic goiter. Endocrinology, 11, 106–16.Google Scholar
Demet, M. M., Ozmen, B., Deveci, A.et al. (2002). Depression and anxiety in hyperthyroidism. Archives of Medical Research, 33, 552–6.Google Scholar
Fahrenfort, J. J., Wilterdirk, A. M. L. & Veen, E. A. (2000). Long-term residual complaints and psychosocial sequelae after remission of hyperthyroidism. Psychoneuroendocrinology, 25, 201–11.Google Scholar
Kathol, R. G. & Delahunt, J. W. (1986). The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria. General Hospital Psychiatry, 8, 23–8.Google Scholar
Kathol, R. G., Turner, R. & Delahunt, J. W. (1986). Depression and anxiety associated with hyperthyroidism. Response to antithyroid therapy. Psychosomatics, 27, 501–5.Google Scholar
Kung, A. W. C. (1995). Life events, daily stresses and coping in patients with Graves' disease. Clinical Endocrinology, 42, 303–8.Google Scholar
Matos-Santos, A., Lacarda Nobre, E., Costa, J. G. E.et al. (2001). Relationship between the number and impact of stressful life events and the onset of Graves' disease and toxic nodular goitre. Clinical Endocrinology, 55, 15–19.Google Scholar
Nath, J. & Sagar, R. (2001). Late-onset bipolar disorder due to hyperthyroidism. Acta Psychiatrica Scandinavica, 104, 72–5.Google Scholar
Rodosavljevic, V. R., Jakovic, S. M. & Marinkovic, J. M. (1996). Stressful life events in the pathogenesis of Graves' disease. European Journal of Endocrinology, 134, 699–701.Google Scholar
Sonino, N. & Fava, G. A. (1998). Psychological aspects of endocrine disease. Clinical Endocrinology, 48, 1–7.Google Scholar
Sonino, N., Fava, G. A., Belluardo, P., Girelli, M. E. & Boscaro, M. (1993 b). Course of depression in Cushing's syndrome: response to treatment and comparison with Graves' disease. Hormone Research, 39, 202–6.Google Scholar
Sonino, N., Girelli, M. E., Boscaro, M.et al. (1993 a). Life events in the pathogenesis of Graves' disease. Acta Endocrinologica, 128, 293–6.Google Scholar
Sonino, N., Navarrini, C., Ruini, C.et al. (2004). Persistent psychological distress in patients treated for endocrine disease. Psychotherapy and Psychosomatics, 73, 78–83.Google Scholar
Stern, R. A., Robinson, B., Thorner, A. R.et al. (1996). A survey of neuropsychiatric complaints in patients with Graves' disease. Journal of Neuropsychiatry and Clinical Neuroscience, 8, 181–5.Google Scholar
Terwee, C. B., Gerding, M. N., Dekker, F. W., Prummel, M. F. & Wiersinga, W. M. (1998). Development of a disease specific quality of life questionnaire for patients with Graves' ophthalmopathy: the GO-QOL. British Journal of Ophthalmology, 82, 773–9.Google Scholar
Winsa, B., Adami, H. O., Bergstrom, R.et al. (1991). Stressful life events and Graves' disease. Lancet, 338, 1475–9.Google Scholar
Wood, L. C. (1998). Support groups for patients with Graves' disease and other thyroid conditions. Endocrinology and Metabolism Clinics of North America, 27, 101–7.Google Scholar
Yoshihuchi, K., Kumano, H., Nomura, S.et al. (1998). Psychological factors influencing the short-term outcome of antithyroid drug therapy in Graves' disease. Psychosomatic Medicine, 60, 592–6.Google Scholar

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