Psychosocial morbidity of Graves' orbitopathy

• Published in: Clinical endocrinology (Oxford) 2005-10, Vol.63 (4), p.395-402
• Main Authors: Kahaly, G. J., Petrak, F., Hardt, J., Pitz, S., Egle, U. T.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Adult; Aged; Biological and medical sciences; Case-Control Studies; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Graves Disease - psychology; Humans; Life Change Events; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Quality of Life; Regression Analysis; Stress, Psychological; Thyroid. Thyroid axis (diseases); Vertebrates: endocrinology
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/j.1365-2265.2005.02352.x

Summary Objective  Ocular diseases markedly impair daily function. In Graves’ orbitopathy (GO), an associated psychosocial burden is present due to disfiguring proptosis and/or diplopia, signs with significant impact on functional status and well‐being. We have therefore surveyed and assessed the psychosocial morbidity of GO. Design  A prospective controlled study on subjects with GO using internationally validated, self‐reporting questionnaires. Patients  One hundred and two consecutive patients with varying degrees of severity and activity of GO. Measurements  Emotional distress, coping styles and quality of life (QoL) were assessed by the Hospital Anxiety and Depression Scale, by a German adaptation of the Ways‐of‐Coping Checklist, and with the 36‐item Short Form, respectively. Stressful events in the 6 months preceding diagnosis were registered with the Life Experience Survey. QoL findings were compared to German reference values, as well as to 102 age‐ and gender‐matched patients, each with type 1 diabetes (insulin‐dependent diabetes mellitus, IDDM) and inflammatory bowel disease (IBD), respectively. Results  Compared to the German reference population, all QoL scales were at a lower rate and were especially decreased in subjects with active and/or severe GO, orbital pain, diplopia and stressful life events. Compared to diabetics, psychosocial scales were considerably reduced in GO (z = −1 vs. 0·1, P