The relevance of physical and psychosocial factors for the quality of life in patients with thyroid-associated orbitopathy (TAO)

Objective: The objective of this study was to investigate quality of life (QoL) in patients with Graves' disease treated with radioiodine or antithyroid drugs. Design and methods: The design of the study consists of an open, prospective, randomized multicenter trial between radioiodine and medical treatment. A total of 308 patients were included in the study group: 145 patients in the medical group and 163 patients in the radioiodine group. QoL was measured with a 36-item Short Form Health Status Survey questionnaire (SF-36) at six time points during the 48-month study period. Results: Patient who developed or got worse of thyroid-associated ophthalmopathy (TAO) at any time point during the 4-year study period (TAO group) had lower QoL when no respect was paid to the mode of treatment. TAO occurred in 75 patients who had radioiodine treatment at some time point during the study period as compared with TAO in 40 medically treated patients (P!0.0009). Comparisons between the group of patients who have had TAO versus the group without TAO, in relation to treatments and time, showed significantly decreased QoL scores for the TAO groups at several time points during the study. In patients without TAO, there were no differences in QoL related to mode of treatment. Conclusions: The QoL in patients with Graves' ophthalmopathy was similar in radioiodine and medically treated patients, but patients who developed or had worsening of TAO had decreased QoL independent of mode of treatment. Furthermore, patients with TAO recovered physically within 1 year but it took twice as long for them to recover mentally.

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“…2a and b). This observation corroborated earlier finding by others when an eye-specific questionnaire had been used (6)(7)(8).…”

Section: Discussionsupporting

confidence: 92%

“…Several studies have shown that TAO is the main reason for discomfort and decreased quality of life (QoL) (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Thyroid-associated ophthalmopathy; quality of life follow-up of patients randomized to treatment with antithyroid drugs or radioiodine

Abraham-Nordling

Wallin²,

Träisk³

et al. 2010

European Journal of Endocrinology

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“…The impact of GO on QOL has been the subject of several recent studies (2)(3)(4)(5)(6)(7)(8)(9)(10), and a disease-specificvalidated QOL questionnaire is now available for clinical use (11)(12)(13). However, psychological aspects of GO -including responses to medical or surgical therapies on psychological function -have not been studied systematically, and we are not aware of any psychological interventional studies in this disease.…”

Section: Introductionmentioning

confidence: 99%

Psychological implications of Graves’ orbitopathy

Coulter

Frewin²,

Krassas³

et al. 2007

eur j endocrinol

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Patients with thyroid eye disease, Graves' orbitopathy (GO), often appear distressed and it is likely that features of the condition such as disturbances in visual function, orbital discomfort and alterations in facial appearance can impart significant psychological morbidity upon the patient, which in turn can be detrimental to their quality of life. When considering the psychological impact of GO, two elements of the disease are important. The disfiguring changes to the eyes and face can have a direct effect upon psychological health, while physical aspects of the disease such as altered visual acuity, diplopia, orbital pain and lacrimation may influence psychological function as a secondary phenomenon, due to interference with daily living. Evidence appears to confirm the anecdotal impression of many clinicians dealing with GO patients that the prevalence of psychological morbidity in this patient group is high. A 'biopsychosocial' approach to care that addresses biological and psychosocial functioning as major determinants of health is an appropriate strategy when treating patients with GO.

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“…Sintomas como depressão, ansiedade e estresse relacionados a atividades sociais e de trabalho estão presentes em grande parte dos indivíduos, embora a OG esteja às vezes camuflada em formas de apresentação que podem não parecer graves ao médico (2,24) . Entretanto, não foram encontrados na literatura estudos que tenham avaliado a autoestima destes pacientes.…”

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