{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:15:48Z","timestamp":1791605748677,"version":"4.3.4"},"reference-count":38,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["etj.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mood disorders are common in Graves\u2019 disease despite treatment. The pathogenic mechanisms involved are unknown and so is whether previous psychiatric disease influences these symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a longitudinal study conducted in Sweden on 65 women with newly diagnosed Graves\u2019 disease and 65 matched controls. Participants were examined during hyperthyroidism and after 15 months of treatment. Examinations included blood sampling, and psychiatric testing with the Comprehensive Psychopathological Rating Scale for Affective Syndromes and the Structured Clinical Interview for DSM-IV \u2013 Axis I Disorders. We also performed two analyses of a national population-based registry to determine previous psychiatric diagnoses and previous prescriptions of psychoactive drugs in (i) all patients we asked to participate and (ii) all Swedish women given a diagnosis of hyperthyroidism during 2013\u20132018, comparing them to matched controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no increased previous psychiatric comorbidity in Graves\u2019 patients compared to controls. There was no higher prevalence of psychiatric diagnoses and prescriptions of psychoactive drugs between (i) included GD patients compared to those who declined participation and (ii) women with a hyperthyroidism diagnosis in 5 years prior to their diagnosis, compared to matched controls. Depression scores and anxiety scores were higher in patients compared to controls both during hyperthyroidism (depression (median (IQR): 7.5 (5.0\u20139.5) vs 1.0 (0.5\u20132.5)\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), anxiety: 7.7 (5.0\u201311) vs 2.5 (1.0\u20134.0)\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and after treatment (depression: 2.5 (1.5\u20135.0) vs 1.5 (0.5-3.5)\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05), anxiety: 4.0 (2.5\u20137.5) vs 3.0 (1.5-5.0)\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). Patients with a previous psychiatric condition, mild eye symptoms, and a younger age had more anxiety at 15 months compared to patients without these symptoms and a higher age (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Graves\u2019 disease affects patients\u2019 mood despite treatment. A previous psychiatric condition, mild eye symptoms, and a younger age increase the vulnerability for long-lasting symptoms and require specific attention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-23-0247","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T15:07:46Z","timestamp":1705072066000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":19,"title":["Psychiatric complications in Graves\u2019 disease"],"prefix":"10.1530","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-9981","authenticated-orcid":true,"given":"Mats","family":"Holmberg","sequence":"first","affiliation":[{"name":"ANOVA, Karolinska University Hospital, Norra Stationsgatan 69, Stockholm, Sweden"},{"name":"Institute of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden"},{"name":"Wallenberg\u2019s Centre of Molecular and Translational Medicine, Region V\u00e4stra G\u00f6taland, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Malmgren","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F","family":"Berglund","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Johansson","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena Filipsson","family":"Nystr\u00f6m","sequence":"additional","affiliation":[{"name":"Wallenberg\u2019s Centre of Molecular and Translational Medicine, Region V\u00e4stra G\u00f6taland, Sweden"},{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"},{"name":"Department of Endocrinology, Sahlgrenska University Hospital, G\u00f6teborg, Sweden"},{"name":"Gothenburg Centre for Person Centred-Care (GPCC), G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"European Journal of Endocrinology","first-page":"501","article-title":"Quality of life in patients with benign thyroid disorders. A review","volume":"154","author":"Watt","year":"2006","unstructured":"Watt TGroenvold MRasmussen AKBonnema SJHegedus LBjorner JB & Feldt-Rasmussen U. Quality of life in patients with benign thyroid disorders. A review. European Journal of Endocrinology2006154501\u2013510. (https:\/\/doi.org\/10.1530\/eje.1.02124)"},{"key":"bib2","series-title":"European Journal of Endocrinology","first-page":"549","article-title":"Impaired health-related quality of life in Graves\u2019 disease. A prospective study","volume":"151","author":"Elberling","year":"2004","unstructured":"Elberling TVRasmussen AKFeldt-Rasmussen UHording MPerrild H & Waldemar G. Impaired health-related quality of life in Graves\u2019 disease. A prospective study. European Journal of Endocrinology2004151549\u2013555. 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(https:\/\/doi.org\/10.1016\/0163-8343(8890084-9)"},{"key":"bib11","series-title":"Archives of Medical Research","first-page":"133","article-title":"Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction","volume":"37","author":"Gulseren","year":"2006","unstructured":"Gulseren SGulseren LHekimsoy ZCetinay POzen C & Tokatlioglu B. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Archives of Medical Research200637133\u2013139. (https:\/\/doi.org\/10.1016\/j.arcmed.2005.05.008)"},{"key":"bib12","series-title":"Nigerian Journal of Clinical Practice","first-page":"276","article-title":"An assessment of psychiatric disturbances in Graves disease in a medical college in eastern India","volume":"15","author":"Chattopadhyay","year":"2012","unstructured":"Chattopadhyay CChakrabarti N & Ghosh S. An assessment of psychiatric disturbances in Graves disease in a medical college in eastern India. Nigerian Journal of Clinical Practice201215276\u2013279. (https:\/\/doi.org\/10.4103\/1119-3077.100620)"},{"key":"bib13","series-title":"Endocrine","first-page":"87","article-title":"The relationship between quality of life, cognition, and thyroid status in Graves\u2019 disease","volume":"63","author":"Riguetto","year":"2019","unstructured":"Riguetto CMNeto AMTambascia MA & Zantut-Wittmann DE. The relationship between quality of life, cognition, and thyroid status in Graves\u2019 disease. Endocrine20196387\u201393. (https:\/\/doi.org\/10.1007\/s12020-018-1733-y)"},{"key":"bib14","series-title":"European Thyroid Journal","article-title":"The relationship between mental fatigue, depression, and cognition in Graves\u2019 disease","volume":"12","author":"Johansson","year":"2023","unstructured":"Johansson BHolmberg MSkau SMalmgren H & Filipsson Nystrom H. 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(https:\/\/doi.org\/10.1089\/thy.2018.0315)"},{"key":"bib18","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1040","article-title":"A longitudinal study of medial temporal lobe volumes in Graves\u2019 disease","volume":"107","author":"Holmberg","year":"2022","unstructured":"Holmberg MMalmgren HHeckemann RAJohansson BKlasson NOlsson ESkau SStarck G & Filipsson Nystrom H. A longitudinal study of medial temporal lobe volumes in Graves\u2019 disease. Journal of Clinical Endocrinology and Metabolism20221071040\u20131052. (https:\/\/doi.org\/10.1210\/clinem\/dgab808)"},{"key":"bib19","series-title":"Women\u2019s Health Reports","first-page":"487","article-title":"Long-term outcome of Graves\u2019 disease: a gender perspective","volume":"4","author":"Calissendorff","year":"2023","unstructured":"Calissendorff JCramon PKHallengren BKhamisi SLantz MPlanck TSjolin GWallin G & Holmberg M. Long-term outcome of Graves\u2019 disease: a gender perspective. Women\u2019s Health Reports20234487\u2013496. (https:\/\/doi.org\/10.1089\/whr.2023.0073)"},{"key":"bib20","series-title":"Clinical Endocrinology","first-page":"395","article-title":"Psychosocial morbidity of Graves\u2019 orbitopathy","volume":"63","author":"Kahaly","year":"2005","unstructured":"Kahaly GJPetrak FHardt JPitz S & Egle UT. Psychosocial morbidity of Graves\u2019 orbitopathy. Clinical Endocrinology200563395\u2013402. (https:\/\/doi.org\/10.1111\/j.1365-2265.2005.02352.x)"},{"key":"bib21","series-title":"European Journal of Endocrinology","first-page":"341","article-title":"Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study","volume":"170","author":"Brandt","year":"2014","unstructured":"Brandt FThvilum MAlmind DChristensen KGreen AHegedus L & Heiberg Brix TH. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study. European Journal of Endocrinology2014170341\u2013348. (https:\/\/doi.org\/10.1530\/EJE-13-0708)"},{"key":"bib22","series-title":"Journal of Clinical and Translational Endocrinology","first-page":"100207","article-title":"Graves\u2019 disease and mental disorders","volume":"19","author":"Fukao","year":"2020","unstructured":"Fukao ATakamatsu JArishima TTanaka MKawai TOkamoto YMiyauchi A & Imagawa A. Graves\u2019 disease and mental disorders. Journal of Clinical and Translational Endocrinology202019100207. (https:\/\/doi.org\/10.1016\/j.jcte.2019.100207)"},{"key":"bib23","series-title":"European Journal of Radiology","first-page":"e43","article-title":"Grey matter abnormalities in untreated hyperthyroidism: a voxel-based morphometry study using the DARTEL approach","volume":"83","author":"Zhang","year":"2014","unstructured":"Zhang WSong LYin XZhang JLiu CWang JZhou DChen B & Lii H. Grey matter abnormalities in untreated hyperthyroidism: a voxel-based morphometry study using the DARTEL approach. 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(https:\/\/doi.org\/10.1530\/EJE-07-0205)"},{"key":"bib26","series-title":"General Hospital Psychiatry","first-page":"133","article-title":"Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves\u2019 disease","volume":"27","author":"Bunevicius","year":"2005","unstructured":"Bunevicius RVelickiene D & Prange AJJr. Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves\u2019 disease. General Hospital Psychiatry200527133\u2013139. (https:\/\/doi.org\/10.1016\/j.genhosppsych.2004.10.002)"},{"key":"bib27","series-title":"BMC Psychiatry","first-page":"2","article-title":"Psychiatric readmissions and their association with physical comorbidity: a systematic literature review","volume":"17","author":"Sprah","year":"2017","unstructured":"Sprah LDernovsek MZWahlbeck K & Haaramo P. Psychiatric readmissions and their association with physical comorbidity: a systematic literature review. BMC Psychiatry2017172. (https:\/\/doi.org\/10.1186\/s12888-016-1172-3)"},{"key":"bib28","series-title":"BMJ Open","first-page":"e031168","article-title":"Structural brain changes in hyperthyroid Graves\u2019 disease: protocol for an ongoing longitudinal, case-controlled study in G\u00f6teborg, Sweden\u2014the CogThy project","volume":"9","author":"Holmberg","year":"2019","unstructured":"Holmberg MOMalmgren HBerglund PBunketorp-Kall LHeckemann RAJohansson BKlasson NOlsson ESkau S & Filipsson Nystrom H. Structural brain changes in hyperthyroid Graves\u2019 disease: protocol for an ongoing longitudinal, case-controlled study in G\u00f6teborg, Sweden\u2014the CogThy project. BMJ Open20199e031168. 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