Quality of Life Research

, Volume 13, Issue 1, pp 45–54 | Cite as

Health-related quality of life in patients with thyroid disorders

  • G.P. Bianchi
  • V. Zaccheroni
  • E. Solaroli
  • F. Vescini
  • R. Cerutti
  • M. Zoli
  • G. Marchesini


Limited reports are available on quality of life (HRQL) in thyroid diseases, and no data are available in euthyroid disorders, such as goiter and Hashimoto thyroiditis. Also, asymptomatic patients may suffer a reduction in perceived health status due to distress related to physical appearance and awareness of disease. We measured HRQL by means of Medical Outcome Study Short Form-36 (SF-36) and Nottingham Health Profile (NHP) questionnaires in 368 patients (hypothyroid, 81; hyperthyroid, 45 (for both states including overt and subclinical states); Hashimoto thyroiditis, 51; euthyroid goiter, 191). The final scores of the domains were compared with age- and sex-adjusted Italian normative values, by computing the effect size. All domains of SF-36, except bodily pain, were reduced in thyroid disease; this was mainly the case of role limitation (both physical and emotional), general health and social functioning. The domains of NHP were less severely affected. HRQL was impaired also in the absence of altered hormone levels. Mood/behavior disturbances were present in a large proportion of patients and were significantly associated with poor HRQL. HRQL was significantly reduced in patients with thyroid diseases referred to a secondary level endocrinology unit. Perceived health status may be considered as an additional outcome of management and therapy of thyroid disorders.

Goiter Mental Health Physical Health Quality of life Thyroid 


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  1. 1.
    McNeil BJ, Weichselbaum R, Pauker SG. Speech and survival: Tradeoffs between quality and quantity of life in laryngeal cancer. N Engl J Med 1981; 305: 982-987.Google Scholar
  2. 2.
    Radacsi A, Bernard W, Feldkamp J, Horster FA, Szabolcs I. Follow up of thyroid hormone parameters in chronically ill geriatric patients: Screening for thyroid disorders at hospital admission justified. Exp Clin Endocrinol Diabetes 2000; 108: 290-293.Google Scholar
  3. 3.
    Knudsen N, Bulow I, Jorgensen T, Laurberg P, Ovesen L, Perrild H. Goitre prevalence and thyroid abnormalities at ultrasonography: A comparative epidemiological study in two regions with slightly different iodine status. Clin Endocrinol 2000; 53: 479-485.Google Scholar
  4. 4.
    Aghini-Lombardi F, Antonangeli L, Vitti P. Epidemiology of endemic goiter in Italy. Ann Ist Super Sanità 1998; 34: 311-314.Google Scholar
  5. 5.
    Jaeschke R, Guyatt G, Cook D, Harper S, Gerstein HC. Spectrum of quality of life impairment in hypothyroidism. Qual Life Res 1994; 3: 323-327.Google Scholar
  6. 6.
    Jaeschke R, Guyatt G, Gerstein H, et al. Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? J Gen Intern Med 1996; 11: 744-749.Google Scholar
  7. 7.
    Gerding MN, Terwee CB, Dekker FW, Koornneef L, Prummel MF, Wiersinga WM. Quality of life in patients with Graves' ophthalmopathy is markedly decreased: Measurement by the medical outcomes study instrument. Thyroid 1997; 7: 885-889.Google Scholar
  8. 8.
    Ljunggren JG, Torring O, Wallin G, et al. Quality of life aspects and costs in treatment of Graves' hyperthyroidism with antithyroid drugs, surgery, or radioiodine: Results from a prospective, randomized study. Thyroid 1998; 8: 653-659.Google Scholar
  9. 9.
    Terwee CB, Gerding MN, Dekker FW, Prummel MF, Wiersinga WM. Development of a disease specific quality of life questionnaire for patients with Graves' ophthalmopathy: The GO-QOL. Br J Ophthalmol 1998; 82: 773-779.Google Scholar
  10. 10.
    Biondi B, Palmieri EA, Fazio S, et al. Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J Clin Endocrinol Metab 2000; 85: 4701-4705.Google Scholar
  11. 11.
    Terwee CB, Gerding MN, Dekker FW, Prummel MF, van der Pol JP, Wiersinga WM. Test-retest reliability of the GO-QOL: A disease-specific quality of life questionnaire for patients with Graves' ophthalmopathy. J Clin Epidemiol 1999; 52: 875-884.Google Scholar
  12. 12.
    Apolone G, Mosconi P. The Italian SF-36 Health Survey: Translation, validation and norming. J Clin Epidemiol 1998; 51: 1025-1036.Google Scholar
  13. 13.
    Bertin M, Niero M, Porchia S. L'adattamento del Nottingham Health Profile al contesto italiano. In: The European Group for Quality of Life and Health Measurement. Profile EGttNH (ed.), Montpellier, France: ESCUBASE s.a.r.l., 1992; 183-223.Google Scholar
  14. 14.
    Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 22: 293-296.Google Scholar
  15. 15.
    McDowell I, Nevell C. Measuring Health: A Guide to Rating Scales and Questionnaires. New York: Oxford University Press, 1987.Google Scholar
  16. 16.
    Cohen J. Statistical Power Analysis for the Behavioural Sciences. New York: Academic Press, 1977.Google Scholar
  17. 17.
    Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care 1989; 27: S178-189.Google Scholar
  18. 18.
    Bianchi G, Loguercio C, Sgarbi D, et al. Reduced quality of life in patients with chronic hepatitis C: Effects of interferon treatment. Dig Liver Dis 2000; 32: 398-405.Google Scholar
  19. 19.
    Marchesini G, Bianchi G, Amodio P, et al. Factors associated with poor health-related quality of life of patients with cirrhosis. Gastroenterology 2001; 120: 170-178.Google Scholar
  20. 20.
    Marchesini G, Solaroli E, Baraldi L, et al. Health-related quality of life in obesity: The role of eating behaviour. Diab Nutr Metab 2000; 13: 156-164.Google Scholar
  21. 21.
    GIVIO Investigators. Impact of follow-up testing on survival and health-related quality of life in breast cancer patients. A multicenter randomized controlled trial. The GIVIO Investigators. JAMA 1994; 271: 1587-1592.Google Scholar
  22. 22.
    Bressan M, Zanchetta M, Michieletto F, et al. Coronary angiography in two defined populations: Padua and Cittadella. G Ital Cardiol 1998; 28: 274-280.Google Scholar
  23. 23.
    Apolone G, Filiberti A, Cifani S, Ruggiata R, Mosconi P. Evaluation of the EORTC QLQ-C30 questionnaire: A comparison with SF-36 Health Survey in a cohort of Italian long-survival cancer patients. Ann Oncol 1998; 9: 549-557.Google Scholar
  24. 24.
    Hunt SM, McKenna SP, McEwen J, Backett EM, Williams J, Papp E. A quantitative approach to perceived health status: A validation study. J Epidemiol Community Health 1980; 34: 281-286.Google Scholar
  25. 25.
    Hunt SM, McEwen J, McKenna SP. Measuring health status: A new tool for clinicians and epidemiologists. J R Coll Gen Pract 1985; 35: 185-188.Google Scholar
  26. 26.
    Shapiro MF, Ware JE Jr, Sherbourne CD. Effects of cost sharing on seeking care for serious and minor symptoms. Results of a randomized controlled trial. Ann Intern Med 1986; 104: 246-251.Google Scholar
  27. 27.
    McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247-263.Google Scholar
  28. 28.
    Rodger AJ, Jolley D, Thompson SC, Lanigan A, Crofts N. The impact of diagnosis of hepatitis C virus on quality of life. Hepatology 1999; 30: 1299-1301.Google Scholar
  29. 29.
    Bommer M, Eversmann T, Pickardt R, Leonhardt A, Naber D. Psychopathological and neuropsychological symptoms in patients with subclinical and remitted hyperthyroidism. Klin Wochenschr 1990; 68: 552-558.Google Scholar
  30. 30.
    Baldini IM, Vita A, Mauri MC, et al. Psychopathological and cognitive features in subclinical hypothyroidism. Prog Neuropsychopharmacol Biol Psychiatry 1997; 21: 925-935.Google Scholar
  31. 31.
    Placidi GP, Boldrini M, Patronelli A, et al. Prevalence of psychiatric disorders in thyroid diseased patients. Neuropsychobiology 1998; 38: 222-225.Google Scholar
  32. 32.
    Apolone G, De Carli G, Brunetti M, Garattini S. Health-related quality of life (HR-QOL) and regulatory issues. An assessment of the European Agency for the Evaluation of Medicinal Products (EMEA) recommendations on the use of HR-QOL measures in drug approval. Pharmacoeconomics 2001; 19: 187-195.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • G.P. Bianchi
    • 1
  • V. Zaccheroni
    • 1
  • E. Solaroli
    • 1
  • F. Vescini
    • 1
  • R. Cerutti
    • 3
  • M. Zoli
    • 1
  • G. Marchesini
    • 2
  1. 1.Dipartimento di Medicina Interna, CardioangiologiaEpatologiaItaly
  2. 2.Cattedra di Malattie del Metabolismo, Alma Mater StudiorumUniversità di BolognaItaly
  3. 3.European Medical Affairs, Bracco Imaging S.p.AMilanoItaly

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