Quality of life in patients with benign thyroid disorders. A review

Abstract

The importance of patient-reported outcomes such as health-related quality of life (HRQL) in clinical research is increasingly acknowledged. In order to yield valid results, the measurement properties of HRQL questionnaires must be thoroughly investigated. One aspect of such a validation process is the demonstration of content validity, i.e. that the questionnaire covers all relevant aspects. We review studies reporting on consequences of thyroid disorders and present the frequency of identified aspects, both overall HRQL issues and classical thyroid symptoms, in order to evaluate which issues are relevant for patients with thyroid diseases. Furthermore, existing questionnaires for thyroid patients are reviewed. A systematic search was performed in the Medline, Cinahl and Psycinfo databases and the reference lists of the relevant articles were hand-searched. Seventy-five relevant studies were identified. According to these studies, patients with untreated thyroid disease suffer from a wide range of symptoms and have major impairment in most areas of HRQL. Furthermore, the studies indicate that impairments in HRQL are also frequent in the long term. Six HRQL questionnaires for thyroid patients were identified. Generally, data supporting the validity of these questionnaires were sparse. According to the available literature, the quality of life of thyroid patients is substantially impaired over a wide range of aspects of HRQL in the untreated phase and continues to be so in many patients also in the long term. Studies systematically exploring the relative importance of these various aspects to thyroid patients are lacking, as is a comprehensive, validated thyroid-specific HRQL questionnaire.European Journal of Endocrinology 154 501-510

Does thyroid surgery for Graves’ disease improve health-related quality of life?

“…As a result, our findings may not be fully comparable with those of other studies. However, the lack of a questionnaire that assesses the psychological status, as well as the general, clinical and psychosocial aspects of GD in all its complexity, as well as the response to medical and/or surgical treatment, is acknowledged in the international literature [2,18,28]. Surprisingly, our results showed that none of the patient characteristics were significantly associated with a higher HRQOL impairment after surgery.…”

“…The incidence of GD is estimated at 5 per 1,000 per year, with a femaleto-male ratio of 7:1 [1]. Patients with untreated GD suffer from a wide range of symptoms, and a substantial portion of them experience limitations in their usual activities, perceive their general health as impaired, and experience social and emotional deterioration [2]. Thus, the impact of GD on the overall well-being of patients cannot be neglected, and some studies have shown that patients with the disease can have a diminished health-related quality of life (HRQOL) [2,3].…”

“…Patients with untreated GD suffer from a wide range of symptoms, and a substantial portion of them experience limitations in their usual activities, perceive their general health as impaired, and experience social and emotional deterioration [2]. Thus, the impact of GD on the overall well-being of patients cannot be neglected, and some studies have shown that patients with the disease can have a diminished health-related quality of life (HRQOL) [2,3]. As a result, the importance of taking the HRQOL into consideration when evaluating thyroid patients has become increasingly recognized as one of the main goals of the various disease treatments [4].…”

Treating primary hypothyroidism with weekly doses of levothyroxine: a randomized, single-blind, crossover study

“…Cardiovascular system alterations are not uncommon and include decreased output, increased peripheral resistance and reduced blood vo lume, leading to pulse pressure narrowing, increased circulation time, and decreased blood flow to the tis sues, which can be well exemplified by the coolness and pallor of the skin (11). Affective disorders, such as para noid and depressive behavior and impairment of quality of life, may also be found (12,13).…”

Hyperthyroidism is associated with work disability and loss of labour market income. A Danish register-based study in singletons and disease-discordant twin pairs

“…Also, psychiatric morbidity, such as psychosis, anxiety disorders and bipolar disease (8), is overrepresented among patients with hyperthyroidism. Hyperthyroid individuals have been reported to have a reduced quality of life (9) and problems with everyday routines, such as housekeeping (10). However, less is known about whether, and if so to which degree, the patients with hyperthyroidism have decreased work ability.…”