medwireNews: People with treated hypothyroidism have a high prevalence of type D personality that may be linked to somatization and negative patient-reported outcomes, show data from the international E-MPATHY trial.
“Type D personality is characterized by a predisposition to pessimism, worry, stress, negative affectivity (NA), and social inhibition,” write Petros Perros (Newcastle University, UK) and co-authors in The Journal of Clinical Endocrinology & Metabolism.
They add that it has been linked to persistent symptoms, impaired quality of life, mental health, treatment outcomes, and poor medication adherence in other conditions, including heart disease, but is not well studied in people with hypothyroidism.
The authors also note that between 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving a serum thyroid stimulating hormone (TSH) level within the reference range.”
In their study, the self-administered Type D Scale-14 questionnaire showed that the prevalence of type D personality was 54.2% among the 3523 study participants (94% women) from 68 countries with self-reported, treated hypothyroidism.
This is higher than the estimated global type D personality prevalence of 21.0% to 38.5%, the researchers remark.
Further analysis showed that type D personality was associated with being in the youngest age categories (≤50 years), non-White ethnicity, having above average household income, having mental illness, receiving treatment with desiccated thyroid extract and levothyroxine and triiodothyronine, having a low most recent TSH level, and having no anxiety, depression, or somatic symptom disorder.
Type D personality was also associated with the patients’ beliefs that thyroid medication did not control their hypothyroidism symptoms, dissatisfaction with hypothyroidism care and treatment, and with the view that hypothyroidism has a negative impact on everyday living.
“These associations are probably driven by NA,” Perros et al remark. They point out that the NA aspect of type D personality predisposes individuals to “chronic stress and physiological and immunological responses, unhealthy behaviors as coping mechanisms, and adverse effects on social relationships and support systems.”
The researchers say that although their findings need to be confirmed in further studies, “it may be assumed that type D personality precedes the onset of hypothyroidism in most cases,” since most patients develop hypothyroidism in middle life.
They continue: “This reasoning suggests that the type D personality traits are not the result of hypothyroidism or its treatment and the poor experiences often described by people with hypothyroidism but that the preexistence of type D personality traits may color the perception of the patient experience.”
The team concludes that “[c]lose collaboration between the disciplines of thyroidology and psychology is likely to be key in progressing our understanding in this area.”
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