Psychological Evaluation of Patients with a Nodular Goiter Before and After Surgical Treatment. (from the chapter) Background: Association between endocrine and mental disorders has been recognized a long time ago, as well as their mutual dependence. In some physical disorders, psychologic factors contribute directly or indirectly to the etiology, in others, psychological symptoms are the direct results of a lesion affecting neural or endocrine organs. One of the key etiological factors is often a short-time or long-time stress and its direct consequence in altered functioning of various hormonal systems. The aim of this study was to evaluate the frequency and characteristic of psychological disorders in the patients with a nodular goiter before and after surgical treatment. Sample and Methods: Sixty patients (14 males/46 females; age 46 +/ 4.8 years) with a nodular goiter who required surgery were studied. Two groups of patients were compared: group 1-euthyroid with nonautonomous "cold" nodules and group 2-euthyroid with autonomous "hot" nodules. Before and after surgical treatment both groups underwent psychological evaluation. DSM IV-TR classification of mental disorders and psychological instruments were employed: semistructured psychiatric interview, MMPI, Zung depression scale and a list of panic symptoms. Results: before surgery using a suitable psychological research, we found the existence of premorbid, hypersensitive and anxious personality structure in most of the examined patients. There were 53 patients (88.3\%) with at least one DSM-IV-TR psychiatric diagnosis before surgery. Before surgical treatment in the both groups the most frequent psychiatric diagnostic findings were: generalized anxiety disorder (43.3\%), mixed anxiety-depression (11,7\%), depression (16.7\%), panic disorder with or without agoraphobia (16.7\%) and with no diagnosis (11.7\%). After surgical treatment in the both groups psychiatric diagnoses were significantly less: generalized anxiety disorder (20\%; p=0.0001), mixed anxiety-depression (5\%; p=0.045), depression (6.7\%; p=0.013), and panic disorder with or without agoraphobia (6.7\%; p=0.013). Psychiatric disturbances in group 1 presented with: generalized anxiety disorder, major depression, and panic disorder with or without agoraphobia (48.9\%, 22.2\%, 13.3\%), while in group 2 presented with: generalized anxiety disorder (26.6\%), mixed anxiety-depression (46.7\%), and panic disorder with or without agoraphobia (26.7\%). In group 1 there were 7 patients (15.6\%) with no psychiatric diagnosis, while in group 2 there were no patients with no psychiatric diagnosis. After surgical treatment the prevalence of generalized anxiety disorder, major depression and panic disorder were significantly lower in group 1 (17.8\%, 8.9\%, 4.4\%), while in group 2 only mixed anxiety-depression (20\%) was lower. Conclusions: Unexpected high percentage of psychiatric disturbances in patients with nodular goiter suggests that psychological evaluation before and after surgical treatment is unavoidable for good assessment and choice of treatment. These patients need attention and psychotherapeutic or psychopharmacological treatment. (PsycINFO Database Record (c) 2007 APA, all rights reserved) https://www.upress.umn.edu/test-division/bibliography/2000-2009/2005/caparevic_psychological_2005 https://www.upress.umn.edu/logo.png

Zorica V Caparevic, Vladimir M Diligenski, Dragos M Stojanovic, and Gradimir D Bojkovic (2005)

Psychological Evaluation of Patients with a Nodular Goiter Before and After Surgical Treatment.

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Adults
Age
Agoraphobia
Anxiety
APA
Attention
Classification
Dependence
Depression
Depression Scale
Diagnosis
Disturbance
Epidemiology
Etiological factors
Etiology
Generalized anxiety disorder
Interview
Major Depression
Mental disorder
MMPI
Need
Panic
Panic disorder
Patients
Personality
Prevalence
Psychiatric diagnoses
Psychiatric interview
Research
School
Stress
Surgery
Symptoms
Time
Treatment
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Psychological Evaluation of Patients with a Nodular Goiter Before and After Surgical Treatment.