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Causal Attributions, Social Support and Psychological Morbidity in Patients Undergoing Thyroid Surgery

  • Yildirim, Nazmiye Kocaman (Department of Consultation Liaison Psychiatry, Istanbul Faculty of Medicine, University of Istanbul) ;
  • Ozcinar, Beyza (Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul) ;
  • Dogan, Selim (Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul) ;
  • Aksakal, Nihat (Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul) ;
  • Sahbaz, Nuri Alper (Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital) ;
  • Tutal, Firat (Department of General Surgery, Kolan Hospital) ;
  • Torun, Bahar Canday (Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul) ;
  • Ozkan, Mine (Department of Consultation Liaison Psychiatry, Istanbul Faculty of Medicine, University of Istanbul) ;
  • Erbil, Yesim (Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul)
  • Received : 2018.06.25
  • Accepted : 2018.10.12
  • Published : 2018.12.31

Abstract

Purpose: The primary objective of the present study was to investigate the course of anxiety and depression in thyroidectomy. The second objective was to investigate the association between somatic symptoms and psychological symptoms, and the final objective was to identify the sociodemographic, clinical, and psychosocial factors that affect psychiatric morbidity. Methods: This prospective study, 101 patients who were admitted to the Endocrine Surgery Clinic of the Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul, with thyroid pathology were included in the study. Data were collected before surgery, and in the early, and late periods after surgery. Data were collected using a semi-structured interview form, a visual analogue scale, and the Hospital Anxiety and Depression Scale. Results: The average scores of anxiety and depression before surgery were statistically significantly higher compared with the early and late periods after surgery (P<0.001). Psychological morbidity was identified about 10% of patients before surgery and remained after thyroidectomy. A poor positive correlation founded between somatic symptoms and psychological condition in period surgery (P<0.05). Various sociodemographic features and psychosocial parameters affected anxiety and depression level (P<0.05). Conclusion: Anxiety and depression level in thyroid diseases decreased after thyroidectomy. These patients may express psychologic distress through somatic symptoms. Screening of psychological morbidity is suggested in patients planned thyroid surgery, especially in women, low-educated, inadequate social support, attributed to psychological causes.

Keywords

References

  1. Yetim I, Kardes K, Karaca S, Sacin A. Our thyroid surgery clinic experience. J Clin Anal Med 2011;2:43-5.
  2. Burmeister LA, Ganguli M, Dodge HH, Toczek T, DeKosky ST, Nebes RD. Hypothyroidism and cognition: preliminary evidence for a specific defect in memory. Thyroid 2001;11:1177-85. https://doi.org/10.1089/10507250152741037
  3. Samuels MH. Psychiatric and cognitive manifestations of hypothyroidism. Curr Opin Endocrinol Diabetes Obes 2014;21:377-83. https://doi.org/10.1097/MED.0000000000000089
  4. Demet MM, Ozmen B, Deveci A, Boyvada S, Adiguzel H, Aydemir O. Depression and anxiety in hyperthyroidism. Arch Med Res 2002;33:552-6. https://doi.org/10.1016/S0188-4409(02)00410-1
  5. Gulseren S, Gulseren L, Hekimsoy Z, Cetinay P, Ozen C, Tokatlioglu B. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Arch Med Res 2006;37:133-9. https://doi.org/10.1016/j.arcmed.2005.05.008
  6. Yilmaz M, Sezer H, Gurler H, Bekar M. Predictors of preoperative anxiety in surgical inpatients. J Clin Nurs 2012;21:956-64. https://doi.org/10.1111/j.1365-2702.2011.03799.x
  7. Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients - experience of a single unit. Acta Anaesthesiol Taiwan 2012;50:3-6. https://doi.org/10.1016/j.aat.2012.02.004
  8. Munafo MR, Stevenson J. Anxiety and surgical recovery. Reinterpreting the literature. J Psychosom Res 2001;51:589-96. https://doi.org/10.1016/S0022-3999(01)00258-6
  9. Shoar S, Naderan M, Aghajani M, Sahimi-Izadian E, Hosseini-Araghi N, Khorgami Z. Prevalence and determinants of depression and anxiety symptoms in surgical patients. Oman Med J 2016;31:176-81. https://doi.org/10.5001/omj.2016.35
  10. Basak F, Hasbahceci M, Guner S, Sisik A, Acar A, Yucel M, et al. Prediction of anxiety and depression in general surgery inpatients: a prospective cohort study of 200 consecutive patients. Int J Surg 2015;23:18-22. https://doi.org/10.1016/j.ijsu.2015.09.040
  11. Ghoneim MM, O'Hara MW. Depression and postoperative complications: an overview. BMC Surg 2016;16:5. https://doi.org/10.1186/s12893-016-0120-y
  12. Miccoli P, Minuto MN, Paggini R, Rucci P, Oppo A, Donatini G, et al. The impact of thyroidectomy on psychiatric symptoms and quality of life. J Endocrinol Invest 2007;30:853-9. https://doi.org/10.1007/BF03349227
  13. Abdul-Sater L, Henry M, Majdan A, Mijovic T, Franklin JH, Brandt MG, et al. What are thyroidectomy patients really concerned about? Otolaryngol Head Neck Surg 2011;144:685-90. https://doi.org/10.1177/0194599811399556
  14. Eskander A, Devins GM, Freeman J, Wei AC, Rotstein L, Chauhan N, et al. Waiting for thyroid surgery: a study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery. Laryngoscope 2013;123:541-7. https://doi.org/10.1002/lary.23503
  15. Pritchard MJ. Using the hospital anxiety and depression scale in surgical patients. Nurs Stand 2011;25:35-41.
  16. Dogan S, Sahbaz NA, Aksakal N, Tutal F, Torun BC, Yildirim NK, et al. Quality of life after thyroid surgery. J Endocrinol Invest 2017;40:1085-90. https://doi.org/10.1007/s40618-017-0635-9
  17. Littman GS, Walker BR, Schneider BE. Reassessment of verbal and visual analog ratings in analgesic studies. Clin Pharmacol Ther 1985;38:16-23. https://doi.org/10.1038/clpt.1985.127
  18. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  19. Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg 1997;8:280-7.
  20. Sung TY, Shin YW, Nam KH, Chang HS, Rhee Y, Park CS, et al. Psychological impact of thyroid surgery on patients with well-differentiated papillary thyroid cancer. Qual Life Res 2011;20:1411-7. https://doi.org/10.1007/s11136-011-9887-6
  21. Agarwal A, Ranjan R, Dhiraaj S, Lakra A, Kumar M, Singh U. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia 2005;60:978-81. https://doi.org/10.1111/j.1365-2044.2005.04332.x
  22. Afifi M. Gender differences in mental health. Singapore Med J 2007;48:385-91.
  23. Topitz A, Benda N, Saumer G, Friedrich F, Konig D, Soulier N, et al. Prevalence and recognition of depression among inpatients of non-psychiatric hospital departments. Neuropsychiatr 2015;29:63-70. https://doi.org/10.1007/s40211-015-0145-y
  24. Ozmen E, Aydemir O. Somatization. Turk Bull Psychiatry 1994;3:30-8.
  25. Matud PM. Gender differences in stress and coping styles. Pers Individ Dif 2004;37:1401-15. https://doi.org/10.1016/j.paid.2004.01.010
  26. Moskowitz D, Vittinghoff E, Schmidt L. Reconsidering the effects of poverty and social support on health: a 5-year longitudinal test of the stress-buffering hypothesis. J Urban Health 2013;90:175-84. https://doi.org/10.1007/s11524-012-9757-8
  27. Suzuki M, Deno M, Myers M, Asakage T, Takahashi K, Saito K, et al. Anxiety and depression in patients after surgery for head and neck cancer in Japan. Palliat Support Care 2016;14:269-77. https://doi.org/10.1017/S1478951515000930
  28. Leventhal H, Leventhal EA, Contrada RJ. Self-regulation, health and behaviour: a perceptual cognitive approach. Psychol Health 1989;13:717-34.
  29. Tiemensma J, Kaptein AA, Pereira AM, Smit JW, Romijn JA, Biermasz NR. Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing's syndrome. Eur J Endocrinol 2011;165:527-35. https://doi.org/10.1530/EJE-11-0307
  30. Oba S, Takatsuka N, Nagata C, Nagao Y, Yamamoto S, Shibuya C, et al. Causal attributions to epidemiological risk factors and their associations to later psychological adjustment among Japanese breast cancer patients. Support Care Cancer 2009;17:3-9. https://doi.org/10.1007/s00520-008-0446-9