PHQ-9 and GAD-7 Score Response After Parathyroidectomy for Primary Hyperparathyroidism: a Systematic Review and Meta-analysis

John Caraway; Matthew Ryan; Alex Yang; Nora Watson; Rhonda Allard; Michael Orestes

doi:10.1002/ohn.698

PHQ-9 and GAD-7 Score Response After Parathyroidectomy for Primary Hyperparathyroidism: a Systematic Review and Meta-analysis

Otolaryngol Head Neck Surg. 2024 Feb 28. doi: 10.1002/ohn.698. Online ahead of print.

Authors

John Caraway¹, Matthew Ryan², Alex Yang², Nora Watson³, Rhonda Allard⁴, Michael Orestes^{2

5}

Affiliations

¹ F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
² Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
³ Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
⁴ James A. Zimble Learning Resource Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
⁵ Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

PMID: 38415869
DOI: 10.1002/ohn.698

Abstract

Objective: Currently, the relationship between parathyroidectomy and objective neuropsychiatric outcomes are not clearly defined. The purpose of this study is to perform the first ever Meta-analysis of preoperative and postoperative PHQ-9 and GAD-7 scores in patients with primary hyperparathyroidism undergoing parathyroidectomy with the goal of identifying a specific psychometric score that could be used as an indication for surgical intervention.

Data sources: A comprehensive search of the literature was performed using PubMed, Embase, PsycINFO, Web of Science, and Ovid All EBM Reviews.

Review methods: Studies met inclusion criteria if they evaluated preoperative and postoperative PHQ-9 and/or GAD-7 scores in patients with primary hyperparathyroidism undergoing parathyroidectomy. Random effects Meta-analyses were used to analyze the compiled data.

Results: The literature search returned 1433 articles for initial review of which 6 (1105 participants) met criteria for inclusion and Meta-analysis. Meta-analysis revealed that primary hyperparathyroidism patients had significantly higher presurgical PHQ-9 scores when compared to control groups. Additionally, patients experienced a statistically significant and sustained decrease in PHQ-9 scores following parathyroidectomy. Notably, there was a dramatic decrease in the percentage of patients with PHQ-9 scores ≥10 (considered clinically significant for depression) following parathyroidectomy.

Conclusion: Patients with primary hyperparathyroidism experience a statistically significant and sustained improvement in PHQ-9 scores following parathyroidectomy. Additionally, symptoms of anxiety and suicidal ideation appear to decrease after parathyroidectomy. We propose that a PHQ-9 score ≥10 could potentially be used as an indication for parathyroidectomy in patients with asymptomatic primary hyperparathyroidism.

Keywords: GAD-7; PHQ-9; anxiety; depression; neuropsychiatric symptoms; parathyroidectomy; primary hyperparathyroidism; psychometric screeners.

Published 2024. This article is a U.S. Government work and is in the public domain in the USA.

Publication types

Review