Endocrine Abstracts

Introduction: Graves’ orbitopathy (GO) is a potentially disfiguring and sight-threatening autoimmune condition that affects 25% to 50% of individuals with Graves’ thyroid disease. Patients often experience disfiguring symptoms which diminish their health-related quality of life. The objective is to investigate in Belgium quality of life in patients with active GO, compared with patients with Graves’ thyroid disease (GD) only and healthy controls.

Methods: At Ghent University Hospital, we included 34 patients with active GO (CAS≥3), 32 patients with GD only and 39 sex- and age- matched healthy controls. Participants completed a survey consisting of demographic questions, medical outcomes, the 21-question version of the Depression Anxiety Stress Scale (DASS21); Study 36-items Form Health Survey (SF-36) and the Illness Cognition Questionnaire.

Results: Both GO an GD group demonstrate a significant mental health burden compared to controls. On measures of anxiety, stress, emotional well-being, and social functioning, both GO and GD reported significantly poorer outcomes than the control group. There was no significant difference between the GO and GD group, suggesting the psychological impact is linked to having GD itself, rather than the complication of orbitopathy. The physical burden of the disease appears to be primarily driven by the presence of orbitopathy. Only the GO group reported significantly worse outcomes for energy/fatigue and limitations due to physical health, compared to the normal controls. GD did not show a significant difference from controls on these physical measures. Comparison between the two patient groups using the Illness Cognition Questionnaire scale showed that the GO group reported significantly higher levels of helplessness, which reflects the more complex and visually prominent nature of their condition.

Conclusion: Having GD delivers a high psychological impact. The physical implications and helplessness are significantly linked to the presence of GO.

References: 1. Lovibond PF et al: The structure of negative emotional states: comparison of DASS with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43. 2. Jenkinson C et al: Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993;306(6890):1437-40. 3. Evers AW et al: Beyond unfavorable thinking: the illness coping questionnaire for chronic diseases. J Consult Clin Psychol. 2001;69(6):1026-36

Keywords: Belgian patient, burden of disease, Graves’ orbitopathy, Graves’ thyroid disease