Examination of quality of life and psychiatric symptoms in childhood Graves’ disease
-
Gözde Yazkan Akgül
and
Özge Köprülü
Abstract
Objectives
The aim of our study is to examine the emotional, behavioral problems, and psychiatric symptoms of children diagnosed with Graves’ disease (GD), to assess their quality of life, and to compare with control group.
Methods
The research was planned as a cross-sectional study and included 16 patients with GD (13 female and three male) and 29 healthy children for control group (19 female and 10 male). Sociodemographic form, Pediatric Quality of Life Inventory, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Strengths and Difficulties Questionnaire (SDQ), Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S), and Affective Reactivity Index scale were applied to the children and their families.
Results
Eighty one percent of GD group (GG) (n=13, mean age 15.1 ± 2.2) and 66 % of control group (CG) (n=19, 14.6 ± 2.2) were girls. No significant difference was found between GG and CG in terms of quality of life, anxiety, and depression scores. GG had higher scores in affective reactivity index, SDQ-P total score, and T-DSM-IV-S total scores (p values 0.039; 0.009; 0.023, respectively). While no significant difference was detected in the T-DSM-IV-S-inattention and hyperactivity scores, significantly higher scores were detected in oppositional defiance and conduct disorder scores (p values 0.172; 0.294; 0.019; 0.027, respectively).
Conclusions
In children with GD, irritability, oppositional defiant, and conduct disorder symptoms have been detected. Children with these mental health symptoms experience behavioral and emotional difficulties in their daily lives. It is important to follow up children with GD for possible comorbid psychiatric disorders.
-
Research ethics: The study protocol was approved by the Tekirdağ Namık Kemal University Medical Faculty Ethics Committee (2022.94.05.21).
-
Informed consent: Informed consent was obtained from all individuals included in this study.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest.
-
Research funding: None declared.
-
Data availability: The raw data can be obtained on request from the corresponding author.
References
1. Léger, J. Graves’ disease in children. Endocr Dev 2014;26:171–82. https://doi.org/10.1159/000363163.Search in Google Scholar PubMed
2. Esen, İ, Bayramoğlu, E, Yıldız, M, Aydın, M, Karakılıç Özturhan, E, Aycan, Z, et al.. Management of thyrotoxicosis in children and adolescents: a Turkish multi-center experience. J Clin Res Pediatr Endocrinol 2019;11:164–72. https://doi.org/10.4274/jcrpe.galenos.2018.2018.0210.Search in Google Scholar PubMed PubMed Central
3. Boiko, J, Léger, J, Raux-Demay, MC, Cabrol, S, Le Bouc, Y, Czernichow, P. Basedow disease in children: clinical and evolutive aspects. Arch Pediatr Organe Off Soc Francaise Pediatr 1998;5:722–30. https://doi.org/10.1016/s0929-693x(98)80052-3.Search in Google Scholar PubMed
4. Jurado-Flores, M, Warda, F, Mooradian, A. Pathophysiology and clinical features of neuropsychiatric manifestations of thyroid disease. J Endocr Soc 2022;6:bvab194. https://doi.org/10.1210/jendso/bvab194.Search in Google Scholar PubMed PubMed Central
5. Chattopadhyay, C, Chakrabarti, N, Ghosh, S. An assessment of psychiatric disturbances in Graves disease in a medical college in eastern India. Niger J Clin Pract 2012;15:276–9. https://doi.org/10.4103/1119-3077.100620.Search in Google Scholar PubMed
6. Fukao, A, Takamatsu, J, Arishima, T, Tanaka, M, Kawai, T, Okamoto, Y, et al.. Graves’ disease and mental disorders. J Clin Transl Endocrinol 2020;19:100207. https://doi.org/10.1016/j.jcte.2019.100207.Search in Google Scholar PubMed PubMed Central
7. Hamed, SA, Attiah, FA, Abdulhamid, SK, Fawzy, M. Behavioral assessment of children and adolescents with Graves’ disease: a prospective study. PLoS One 2021;16:e0248937. https://doi.org/10.1371/journal.pone.0248937.Search in Google Scholar PubMed PubMed Central
8. Zader, SJ, Williams, E, Buryk, MA. Mental health conditions and hyperthyroidism. Pediatrics 2019;144:e20182874. https://doi.org/10.1542/peds.2018-2874.Search in Google Scholar PubMed
9. Biondi, B, Palmieri, EA, Fazio, S, Cosco, C, Nocera, M, Saccà, L, et al.. Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J Clin Endocrinol Metab 2000;85:4701–5. https://doi.org/10.1210/jc.85.12.4701.Search in Google Scholar
10. Hirtz, R, Keesen, A, Hölling, H, Hauffa, BP, Hinney, A, Grasemann, C. No effect of thyroid dysfunction and autoimmunity on health-related quality of life and mental health in children and adolescents: results from a nationwide cross-sectional study. Front Endocrinol 2020;11:454. https://doi.org/10.3389/fendo.2020.00454.Search in Google Scholar PubMed PubMed Central
11. Goodman, R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 1997;38:581–6. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x.Search in Google Scholar PubMed
12. Goodman, R. The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999;40:791–9. https://doi.org/10.1017/s0021963099004096.Search in Google Scholar
13. Guvenir, T, Ozbek, A, Baykara, B, Arkar, H, Şentürk, B, İncekaş, S. Psychometric properties of the Turkish version of the Strengths and Difficulties Questionnaire (SDQ). Turk J Child Adolesc Ment Health 2008;15:32–40.Search in Google Scholar
14. Gormez, V, Kilincaslan, A, Ebesutani, C, Orengul, AC, Kaya, I, Ceri, V, et al.. Psychometric properties of the parent version of the revised child anxiety and depression scale in a clinical sample of Turkish children and adolescents. Child Psychiatry Hum Dev 2017;48:922–33. https://doi.org/10.1007/s10578-017-0716-1.Search in Google Scholar PubMed
15. Turgay, A. Disruptive behavior disorders child and adolescent screening and rating scales for children, adolescents, parents and teachers. West Bloomfield, MI: Integrative Therapy Institute Publication; 1994.Search in Google Scholar
16. Ercan, ES, Amado, S, Somer, O, Çıkoğlu, S. Development of a test battery for the assessment of attention deficit hyperactivity disorder. Turk J Child Adolesc Ment Health 2001;8:132–44.Search in Google Scholar
17. Kocael, Ö. Çocuk ve ergenlerde irritabilite: Duygusal reaktivite indeksi’nin Türkçe geçerlilik güvenilirlik çalışması. Turkey: Diss. Bursa Uludag University; 2015.Search in Google Scholar
18. Varni, JW, Burwinkle, TM, Seid, M, Skarr, D. The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003;3:329–41. https://doi.org/10.1367/1539-4409(2003)003<0329:tpaapp>2.0.co;2.10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2Search in Google Scholar
19. Çakin Memik, N, Ağaoğlu, B, Coşkun, A, Üneri, ÖŞ, Karakaya, I. The validity and reliability of the Turkish pediatric quality of life inventory for children 13–18 years old. Türk Psikiyatri Derg 2007;18:353–63.Search in Google Scholar
20. Siegmann, EM, Müller, HHO, Luecke, C, Philipsen, A, Kornhuber, J, Grömer, TW. Association of depression and anxiety disorders with autoimmune thyroiditis: a systematic review and meta-analysis. JAMA Psychiatr 2018;75:577–84. https://doi.org/10.1001/jamapsychiatry.2018.0190.Search in Google Scholar
21. Lane, LC, Rankin, J, Cheetham, T. A survey of the young person’s experience of Graves’ disease and its management. Clin Endocrinol 2021;94:330–40. https://doi.org/10.1111/cen.14359.Search in Google Scholar
22. Cramon, P, Winther, KH, Watt, T, Bonnema, SJ, Bjorner, JB, Ekholm, O, et al.. Quality-of-life impairments persist six months after treatment of Graves’ hyperthyroidism and toxic nodular goiter: a prospective cohort study. Thyroid 2016;26:1010–8. https://doi.org/10.1089/thy.2016.0044.Search in Google Scholar
23. Vita, R, Caputo, A, Quattropani, MC, Watt, T, Feldt-Rasmussen, U, Puleio, P, et al.. Quality of life in patients with hyperthyroidism: where do we stand? Mediterr J Clin Psychol 2020;8.Search in Google Scholar
24. Riguetto, CM, Neto, AM, Tambascia, MA, Zantut-Wittmann, DE. The relationship between quality of life, cognition, and thyroid status in Graves’ disease. Endocrine 2019;63:87–93. https://doi.org/10.1007/s12020-018-1733-y.Search in Google Scholar
25. Engum, A, Bjøro, T, Mykletun, A, Dahl, AA. An association between depression, anxiety and thyroid function – a clinical fact or an artefact? Acta Psychiatr Scand 2002;106:27–34. https://doi.org/10.1034/j.1600-0447.2002.01250.x.Search in Google Scholar
26. Bunevicius, R, Prange, AJ. Psychiatric manifestations of Graves’ hyperthyroidism: pathophysiology and treatment options. CNS Drugs 2006;20:897–909. https://doi.org/10.2165/00023210-200620110-00003.Search in Google Scholar
27. Hage, MP, Azar, ST. The link between thyroid function and depression. J Thyroid Res 2012;2012:1–8. https://doi.org/10.1155/2012/590648.Search in Google Scholar PubMed PubMed Central
28. Demmer, DH, Hooley, M, Sheen, J, McGillivray, JA, Lum, JAG. Sex differences in the prevalence of oppositional defiant disorder during middle childhood: a meta-analysis. J Abnorm Child Psychol 2017;45:313–25. https://doi.org/10.1007/s10802-016-0170-8.Search in Google Scholar PubMed
29. Ahmed, OM, El‐Gareib, AW, El‐bakry, AM, Abd El‐Tawab, SM, Ahmed, RG. Thyroid hormones states and brain development interactions. Int J Dev Neurosci 2008;26:147–209. https://doi.org/10.1016/j.ijdevneu.2007.09.011.Search in Google Scholar PubMed
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Tackling access and payer barriers for growth hormone therapy in Saudi Arabia: a consensus statement for the Saudi Working Group for Pediatric Endocrinology
- Original Articles
- Does an episode of diabetic ketoacidosis affect thyroid function tests in pediatric patients?
- Association between proinflammatory cytokines and arterial stiffness in type 1 diabetic adolescents
- Endocrinological and metabolic profile of Gaucher disease patients treated with enzyme replacement therapy
- Diurnal 11-ketotestosterone and 17-hydroxyprogesterone saliva profiles in paediatric classical congenital adrenal hyperplasia
- Growth after pediatric kidney transplantation: a 25-year study in a pediatric kidney transplant center
- Long term clinical follow up of four patients with Wolfram syndrome and urodynamic abnormalities
- Evaluation of copeptin in children after stimulation with clonidine or L-Dopa
- Examination of quality of life and psychiatric symptoms in childhood Graves’ disease
- Timing of onset of menses after GnRH agonist treatment for central precocious puberty
- Implementation of the Mind Youth Questionnaire (MY-Q) for routine health-related quality of life screening of adolescents with type 1 diabetes in a large tertiary care center
- Case Reports
- Medulloblastoma in a child with osteoma cutis – a rare association due to loss of GNAS expression
- Ectopic lingual thyroid with subclinical hypothyroidism in children
- Pituitary stalk interruption syndrome due to novel ROBO1 mutation presenting as combined pituitary hormone deficiency and central diabetes insipidus
- A 14-year-old girl with premature ovarian insufficiency but with a positive pregnancy test
Articles in the same Issue
- Frontmatter
- Review
- Tackling access and payer barriers for growth hormone therapy in Saudi Arabia: a consensus statement for the Saudi Working Group for Pediatric Endocrinology
- Original Articles
- Does an episode of diabetic ketoacidosis affect thyroid function tests in pediatric patients?
- Association between proinflammatory cytokines and arterial stiffness in type 1 diabetic adolescents
- Endocrinological and metabolic profile of Gaucher disease patients treated with enzyme replacement therapy
- Diurnal 11-ketotestosterone and 17-hydroxyprogesterone saliva profiles in paediatric classical congenital adrenal hyperplasia
- Growth after pediatric kidney transplantation: a 25-year study in a pediatric kidney transplant center
- Long term clinical follow up of four patients with Wolfram syndrome and urodynamic abnormalities
- Evaluation of copeptin in children after stimulation with clonidine or L-Dopa
- Examination of quality of life and psychiatric symptoms in childhood Graves’ disease
- Timing of onset of menses after GnRH agonist treatment for central precocious puberty
- Implementation of the Mind Youth Questionnaire (MY-Q) for routine health-related quality of life screening of adolescents with type 1 diabetes in a large tertiary care center
- Case Reports
- Medulloblastoma in a child with osteoma cutis – a rare association due to loss of GNAS expression
- Ectopic lingual thyroid with subclinical hypothyroidism in children
- Pituitary stalk interruption syndrome due to novel ROBO1 mutation presenting as combined pituitary hormone deficiency and central diabetes insipidus
- A 14-year-old girl with premature ovarian insufficiency but with a positive pregnancy test
