Health-related quality of life, anxiety and depression in thyroid cancer patients under short-term hypothyroidism and TSH-suppressive levothyroxine treatment

Eur J Endocrinol. 2005 Dec;153(6):755-63. doi: 10.1530/eje.1.02047.

Abstract

Objective: Very few previous studies have compared the degree of health-related quality of life (HRQL), depression and anxiety of differentiated thyroid cancer patients (DTC) under short-term hypothyroid-ism and levothyroxine treatment.

Methods: Using patient-completed instruments, we examined the frequency of physical complaints, HRQL, anxiety and depression in 130 DTC patients hospitalized for radioiodine therapy or whole-body diagnostics (age 52 years, female 71%) under short-term hypothyroidism (4 weeks of levothyroxine withdrawal; DTC-H) and in 100 DTC out-patients under TSH-suppressive doses of levothyroxine subsequent to radioiodine therapy (DTC-L; age 49 years, female 81%).

Results: Compared with the German general population, DTC-H as well as DTC-L patients had significantly impaired HRQL. Notably, the decrease in HRQL was significantly higher in DTC-H than in DTC-L patients. Surprisingly, the prevalence of anxiety (44.6%) but not depression (17.7%) was much higher in the DTC-H patients than in the general population. In contrast to expectations, similar results for anxiety (44.0%) and depression (17.6%) were observed in the DTC-L patients.

Conclusions: This mounting evidence suggests that a consistent pattern of HRQL impairment is experienced by patients with DTC. The high frequency of anxiety and the significantly reduced HRQL should be considered in the aftercare of DTC patients.

MeSH terms

  • Adult
  • Affect
  • Aged
  • Anxiety Disorders / etiology*
  • Carcinoma, Papillary / psychology
  • Cross-Sectional Studies
  • Depression / etiology*
  • Female
  • Humans
  • Hypothyroidism / chemically induced
  • Male
  • Middle Aged
  • Quality of Life*
  • Substance Withdrawal Syndrome
  • Thyroid Neoplasms / psychology*
  • Thyroid Neoplasms / radiotherapy
  • Thyrotropin / drug effects
  • Thyroxine / adverse effects
  • Thyroxine / therapeutic use

Substances

  • Thyrotropin
  • Thyroxine