Endocrine Abstracts

Introduction: Reduction of quality of life in patients with chronic hypoparathyroidism (HPT) has been reported by several studies. Additionally, self-report data point to a higher prevalence of anxiety disorders in HPT compared to patients after thyroidectomy.

Objectives: To characterize psychiatric diseases in a systematically reviewed cohort of patients with chronic HPT.

Methods: We systematically assessed psychiatric comorbidities in a well-characterized cohort of patients with chronic HPT (n=133) using standardized questionnaires (depression: Patient Health Questionnaire (PHQ9), Beck Depression Inventory (BDI2), anxiety: State-Trait Anxiety Inventory (STAI)) and further performed a diagnostic interview using the Mini-DIPS (n=103).

Results: Out of the 103 interviewed patients, 69% were female (mean age 58±11 years). 92% presented with postoperative HPT. The STAI provides a screening tool to assess both state (X1) and trait (X2) anxiety separately. Scores range from 20-80 with higher scores being positively correlated with higher levels of anxiety. In the STAI X1 18% of patients scored between 40 and 50 and 18% of patients had a score above 50 (mean 41±13). Regarding trait anxiety (STAI X2) 21% of patients had values between 40 and 50, whereas 20% scored above 50 points (mean 40±12). In contrast, most patients with chronic HPT did not show markedly elevated scores in PHQ9 (81% with scores below 9), as well as BDI2 (71.4% with scores below 13). No significant correlations could be observed between serum calcium, serum phosphate, parathyroid hormone, TSH, 25-OH-Vitamin D levels, disease duration or age and scores of STAI X1, X2 and PHQ9, whereas STAI-X1 and –X2, PHQ9 and BDI-2-scores significantly correlated with HPT symptom severity (all P<0.001, Person’s r X1: 0.389, X2: 0.321, PHQ9: 0.411, BDI2: 0.478). In the diagnostic interviews, anxiety disorder was found in 42% of patients (agoraphobia n=18, specific phobia n=17, panic syndrome n=11, generalized anxiety disorder n=12, social phobia n=6).

Conclusion: The performance of systematic screening as well as diagnostic interview for psychiatric disorders in HPT showed a high prevalence of anxiety disorders despite established treatment of HPT. However, the pathophysiology still remains unclear.