Quality of life and neuropsychiatric disorders in patients with Graves' Orbitopathy: Current concepts

Alice Bruscolini; Marta Sacchetti; Maurizio La Cava; Marcella Nebbioso; Angela Iannitelli; Adele Quartini; Alessandro Lambiase; Massimo Ralli; Armando de Virgilio; Antonio Greco

doi:10.1016/j.autrev.2017.12.012

Quality of life and neuropsychiatric disorders in patients with Graves' Orbitopathy: Current concepts

Autoimmun Rev. 2018 Jul;17(7):639-643. doi: 10.1016/j.autrev.2017.12.012. Epub 2018 May 2.

Authors

Affiliations

¹ Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: alice.bruscolini@uniroma1.it.
² Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: marta.sacchetti@uniroma1.it.
³ Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: maurizio.lacava@uniroma1.it.
⁴ Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: marcella.nebioso@uniroma1.it.
⁵ Department of Biotechnological and Applied Clinical Sciences, University of l'Aquila, Italy.
⁶ Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine "Sapienza" University of Rome, DSM ASL/LT - Unit of Psychiatry, "A. Fiorini" Hospital, Via Firenze, 04019 Terracina, LT, Italy.
⁷ Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: alessandro.lambiase@uniroma1.it.
⁸ Department of Oral and Maxillofacial Sciences, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: massimo.ralli@uniroma1.it.
⁹ Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: armando.devirgilio@uniroma1.it.
¹⁰ Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Electronic address: antonio.greco@uniroma1.it.

PMID: 29729448
DOI: 10.1016/j.autrev.2017.12.012

Abstract

Graves' disease (GD) is an autoimmune chronic thyroiditis frequently associated with development of Graves' orbitopathy (GO) characterized by proptosis, strabismus, impairment of visual function, ocular surface inflammation and dry eye. As consequence, patients with GO experience impairment of quality of life and social function and could develop a neurobehavioral syndrome, ranging from anxious to depressive or psychotic disorders. To date, the pathogenic mechanism underlying neuropsychiatric disorders in patients with GD has not been clearly understood. In fact, the development of neuropsychiatric disorders in patients with GO has been associated with both the detrimental effects of the altered circulating thyroid hormones on the nervous system, and with the psychological discomfort caused by poor quality of life, reduced social interactions and relapsing course of the disease. This paper summarizes current evidence on neuropsychiatric abnormalities in Graves' disease focusing on its impact on QoL and psychosocial function. We remark the importance of a multidisciplinary approach and we emphasize the potential benefit of neuropsychiatric approach on disease perception, patient compliance to medical and/or surgical treatment and clinical outcomes.

Keywords: Graves' disease; Graves' orbitopathy; Neuropsychiatric disorders; Quality of Life.

Publication types

Review

MeSH terms

Graves Ophthalmopathy / complications*
Graves Ophthalmopathy / pathology
Graves Ophthalmopathy / psychology*
Graves Ophthalmopathy / therapy
Humans
Mental Disorders / etiology
Mental Disorders / pathology
Quality of Life