Hypothyroidism and Type D Personality: Results From E-MPATHY, a Cross-sectional International Online Patient Survey

Petros Perros; Endre Vezekenyi Nagy; Enrico Papini; Juan Abad-Madroñero; Peter Lakwijk; Alan J Poots; Floortje Mols; Laszlo Hegedüs

doi:10.1210/clinem/dgae140

Hypothyroidism and Type D Personality: Results From E-MPATHY, a Cross-sectional International Online Patient Survey

J Clin Endocrinol Metab. 2024 Apr 9:dgae140. doi: 10.1210/clinem/dgae140. Online ahead of print.

Authors

Petros Perros¹, Endre Vezekenyi Nagy², Enrico Papini³, Juan Abad-Madroñero⁴, Peter Lakwijk⁵, Alan J Poots⁴, Floortje Mols⁶, Laszlo Hegedüs⁷

Affiliations

¹ Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
² Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary.
³ Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome 00041, Italy.
⁴ Data Science and Insight Team, Picker Institute Europe, Oxford, Oxfordshire OX4 2JY, UK.
⁵ Thyroid Federation International, Transpolispark, Hoofddorp 2132 WT, The Netherlands.
⁶ Department of Medical and Clinical Psychology, Tilburg University, Tilburg 5000 LE, The Netherlands.
⁷ Department of Endocrinology, Odense University Hospital, Odense 5000, Denmark.

PMID: 38591918
DOI: 10.1210/clinem/dgae140

Abstract

Context: Between 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving biochemical euthyroidism. The underlying causes are unclear. Type D personality (a vulnerability factor for general psychological distress) is associated with poor health status and symptom burden but has not been studied in people with hypothyroidism.

Objective: To investigate type D personality in hypothyroidism and explore associations with other characteristics and patient-reported outcomes.

Design: Multinational, cross-sectional survey.

Setting: Online.

Participants: Individuals with self-reported, treated hypothyroidism.

Intervention: Questionnaire.

Main outcome measures: Type D personality and associations with baseline characteristics, control of the symptoms of hypothyroidism by medication, satisfaction with care and treatment of hypothyroidism, impact of hypothyroidism on everyday living.

Results: A total of 3915 responses were received, 3523 of which were valid. The prevalence of type D personality was 54.2%. Statistically significant associations were found between type D personality and several respondent characteristics (age, marital status, ethnicity, household income, comorbidities, type of treatment for hypothyroidism, most recent TSH level), anxiety, depression, somatization, poor control of the symptoms of hypothyroidism by medication, dissatisfaction with care and treatment of hypothyroidism, and a negative impact of hypothyroidism on everyday living).

Discussion: Our study found a high prevalence of type D personality among people with hypothyroidism who responded to the survey. Type D personality may be an important determinant of dissatisfaction with treatment and care among people with hypothyroidism. Our findings require independent confirmation. Close collaboration between the disciplines of thyroidology and psychology is likely to be key in progressing our understanding in this area.

Keywords: hypothyroidism; questionnaire; survey; type D personality.

Grants and funding

IBSA Institut Biochimique SA