Quality of Life in Patients with Hyperthyroidism: Where do we stand?

Roberto Vita, Andrea Caputo, Maria Catena Quattropani, Torquil Watt, Ulla Feldt-Rasmussen, Paola Puleio, Salvatore Benvenga, Gabriella Martino


Introduction. Increasing interest exists concerning the physical and mental wellbeing of patients with hyperthyroidism.

Aim. This review aims at gathering the most updated literature on the quality of life (QoL) in patients with hyperthyroidism.

Method: We searched PubMed from inception to May 20, 2020 for English language studies using the following entries: “hyperthyroidism AND quality of life”, “Graves’ disease AND quality of life”, “diffuse toxic goiter AND quality of life”, “toxic nodular goiter AND quality of life”, “subclinical hyperthyroidism AND quality of life”. Thirty-nine papers were finally reviewed.

Results: Patients with hyperthyroidism have worse QoL than euthyroid subjects, especially if they have Graves’ disease and Graves’ orbitopathy. Treatment of hyperthyroidism with restoration of euthyroidism may not fully restore QoL even after many years, indicating that such patients have difficulties adapting to and coping with their illness, thus experiencing marked and longstanding limitations in physical, mental and psychosocial functioning.

Conclusion. As differences exist on long-term outcomes between therapeutic options for hyperthyroidism, it is logical to hypothesize related differences in long-term changes in QoL. Future clinical and psychological studies could monitor QoL and its related domains across different stages of disease and deepen patients’ trajectories of illness experience and the use of coping strategies to face their condition.


Clinical Psychology; Graves’ disease; Graves’ orbitopathy; Hyperthyroidism; Quality of life; Patient-reported outcome measures; SF-36; Subclinical hyperthyroidism; ThyPRO; GO-QOL.

Full Text:



Abraham-Nordling, M., Törring, O., Hamberger, B., Lundell, G., Tallstedt, L., Calissendorff, J., & Wallin, G. (2005). Graves' disease: a long-term quality-of-life follow up of patients randomized to treatment with antithyroid drugs, radioiodine, or surgery. Thyroid, 15(11), 1279-1286.


Abraham-Nordling, M., Wallin, G., Träisk, F., Berg, G., Calissendorff, J., Hallengren, B., ... & Lundell, G. (2010). Thyroid-associated ophthalmopathy; quality of life follow-up of patients randomized to treatment with antithyroid drugs or radioiodine. European Journal of Endocrinology, 163(4), 651.


Al-Adhami, A., Craig, W., & Krukowski, Z. H. (2012). Quality of life after surgery for Graves' disease: comparison of those having surgery intended to preserve thyroid function with those having ablative surgery. Thyroid, 22(5), 494-500.


Albrecht, G. L., & Devlieger, P. J. (1999). The disability paradox: high quality of life against all odds. Social Science & Medicine, 48(8), 977-988. https://doi.org/10.1016/S0277-9536(98)00411-0

Bălălău, C., Voiculescu, Ș. T. E. F. A. N., Motofei, I., Scăunașu, R. V., & Negrei, C. (2015). Low dose tamoxifen as treatment of benign breast proliferative lesions. Farmacia, 63(3), 371-75.

Barberis, N., Martino, G., Calaresi, D., Žvelc, G. (2020). Development of the italian version of the test of object relations-short form. Clinical Neuropsychiatry, 17 (1), 24-33. 10.36131/ clinicalnpsych20200103.

Bauer, M., Priebe, S., Berghöfer, A., Bschor, T., Kiesslinger, U., & Whybrow, P. C. (2001). Subjective response to and tolerability of long-term supraphysiological doses of levothyroxine in refractory mood disorders. Journal of Affective Disorders, 64(1), 35-42. https://doi.org/10.1016/S0165-0327(00)00215-9

Bell, R. J., Rivera-Woll, L., Davison, S. L., Topliss, D. J., Donath, S., & Davis, S. R. (2007). Well-being, health-related quality of life and cardiovascular disease risk profile in women with subclinical thyroid disease - a community-based study. Clinical Endocrinology, 66(4), 548–556.


Bergner, M., Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981). The Sickness Impact Profile: development and final revision of a health status measure. Medical Care, 787-805. https://doi.org/10.1097/00005650-198108000-00001

Bertin, G., Niero, M., & Porchia, S. (1992). L’adattamento del Nottingham Health Profile al contesto italiano. European Group for Quality of Life Related Measures: Nottingham Health Profile: Euroguide, Montpellier, 183-224.

Bianchi, G. P., Zaccheroni, V., Solaroli, E., Vescini, F., Cerutti, R., Zoli, M., & Marchesini, G. (2004). Health-related quality of life in patients with thyroid disorders. Quality of Life Research, 13(1), 45-54.


Biondi, B., Palmieri, E. A., Fazio, S., Cosco, C., Nocera, M., Saccà, L., ... & Perticone, F. (2000). Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. The Journal of Clinical Endocrinology & Metabolism, 85(12), 4701-4705.


Boesen, V. B., Feldt-Rasmussen, U., Bjorner, J. B., Cramon, P., Groenvold, M., Nygaard, B., ... & Watt, T. (2018a). How should thyroid-related quality of life be assessed? Recalled patient-reported outcomes compared to here-and-now measures. Thyroid, 28(12), 1561-1570. https://doi.org/10.1089/thy.2018.0210

Boesen, V. B., Nissen, S. B., Groenvold, M., Bjorner, J. B., Hegedüs, L., Bonnema, S. J., ... & Watt, T. (2018b). Conversion of standard retrospective patient-reported outcomes to momentary versions: cognitive interviewing reveals varying degrees of momentary compatibility. Quality of Life Research, 27(4), 1065-1076.


Bové, K. B., Watt, T., Vogel, A., Hegedüs, L., Bjørner, J. B., Groenvold, M., ... & Feldt-Rasmussen, U. (2014). Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre. European thyroid journal, 3(3), 173-178. https://doi.org/10.1159/000365211

Bradley, E. A., Sloan, J. A., Novotny, P. J., Garrity, J. A., Woog, J. J., & West, S. K. (2006). Evaluation of the National Eye Institute visual function questionnaire in Graves’ ophthalmopathy. Ophthalmology, 113(8), 1450-1454. https://doi.org/10.1016/j.ophtha.2006.02.060

Bruscolini, A., Sacchetti, M., La Cava, M., Nebbioso, M., Iannitelli, A., Quartini, A., ... & Greco, A. (2018). Quality of life and neuropsychiatric disorders in patients with Graves' Orbitopathy: Current concepts. Autoimmunity Reviews, 17(7), 639-643. https://doi.org/10.1016/j.autrev.2017.12.012

Bukvic, B., Zivaljevic, V., Sipetic, S., Diklic, A., Tausanovic, K., Stojanovic, D., ... & Paunovic, I. (2015). Improved quality of life in hyperthyroidism patients after surgery. Journal of Surgical Research, 193(2), 724-730.


Burch, H. B., Burman, K. D., & Cooper, D. S. (2012). A 2011 survey of clinical practice patterns in the management of Graves' disease. The Journal of Clinical Endocrinology & Metabolism, 97(12), 4549-4558.


Caputo, A. (2014). Exploring quality of life in Italian patients with rare disease: a computer-aided content analysis of illness stories. Psychology, Health & Medicine, 19(2), 211-221.


Caputo, A. (2019). Psychodynamic insights from narratives of people with amyotrophic lateral sclerosis: A qualitative phenomenological study. Mediterranean Journal of Clinical Psychology, 7(2).


Carlé, A., Pedersen, I. B., Knudsen, N., Perrild, H., Ovesen, L., Rasmussen, L. B., & Laurberg, P. (2011). Epidemiology of subtypes of hyperthyroidism in Denmark: a population-based study. European journal of endocrinology, 164(5), 801-809. https://doi.org/10.1530/EJE-10-1155

Carr-Hill, R. A. (1992). Health related quality of life measurement-Euro style. Health Policy, 20(3), 321-328.


Catalano, A., Martino, G., Bellone, F., Papalia, M., Lasco, C., Basile G., Sardella A., Nicocia G., Morabito N., Lasco A. (2019). Neuropsychological assessment in elderly men with benign prostatic hyperplasia treated with dutasteride”. Clinical Drug investigation, 39(1), 97-102. https://doi.org/10.1007/s40261-018-0720-7

Chattopadhyay, C., Chakrabarti, N., & Ghosh, S. (2012). An assessment of psychiatric disturbances in Graves disease in a medical college in eastern India. Nigerian Journal of Clinical Practice, 15(3), 276-279.


Cohen, J., & Biesecker, B. (2010). Quality of life in rare genetic conditions: A systematic review of the literature. American Journal of Medical Genetics Part A, 152A, 1136–1156.


Conaglen, H. M., Tamatea, J. A., Conaglen, J. V., & Elston, M. S. (2018). Treatment choice, satisfaction and quality of life in patients with Graves’ disease. Clinical Endocrinology, 88(6), 977-984.


Conversano, C. (2019). Opinion article: common psychological factors in chronic diseases. Frontiers in Psychology, 10:2727. https://doi.org/10.3389/fpsyg.2019.02727

Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, self-compassion, and empathy among health care professionals. What’s new? A systematic review. Frontiers in Psychology, 11:1683. https://doi.org/10.3389/fpsyg.2020.01683

Conversano, C., Di Giuseppe, M., Ciacchini, R., Miccoli, M., Gemignani, A., & Orrù, G. (2020). Mindfulness as psychological resource against the traumatic experience of COVID-19. Frontiers in Psychology, accepted. https://doi.org/10.3389/fpsyg.2020.01900.

Cooper, D. S., & Biondi, B. (2012). Subclinical thyroid disease. The Lancet, 379(9821), 1142-1154.


Cramon, P., Winther, K. H., Watt, T., Bonnema, S. J., Bjorner, J. B., Ekholm, O., ... & Rasmussen, Å. K. (2016). Quality-of-life impairments persist six months after treatment of Graves' hyperthyroidism and toxic nodular goiter: a prospective cohort study. Thyroid, 26(8), 1010-1018.


Crisanti, P., Omri, B., Hughes, E. J., Meduri, G., Hery, C., Clauser, E., ... & Saunier, B. (2001). The expression of thyrotropin receptor in the brain. Endocrinology, 142(2), 812-822.


Dayan, C. M., & Panicker, V. (2013). Hypothyroidism and depression. European Thyroid Journal, 2(3), 168-179. https://doi.org/10.1159/000353777

Delfino, L. C., Zunino, A., Sapia, V., Croome, M. D. C. S., Ilera, V., & Gauna, A. T. (2017). Related quality of life questionnaire specific to dysthyroid ophthalmopathy evaluated in a population of patients with Graves’ disease. Archives of endocrinology and metabolism, 61(4), 374-381. https://doi.org/10.1590/2359-3997000000252

Di Giuseppe, M., Miniati, M., Miccoli, M., Ciacchini, R., Orrù, G., Lo Sterzo, R., Di Silvestre, A., Conversano, C. (2020). Defensive responses to stressful life events associated with cancer diagnosis. Mediterranean Journal of Clinical Psychology, 8(1), 1-22. https://doi.org/10.6092/2282-1619/mjcp-2384

Di Giuseppe, M., Di Silvestre, A., Lo Sterzo, R., Hitchcott, P., Gemignani, A., & Conversano, C. (2019). Qualitative and quantitative analysis of the defense profile in Breast Cancer women: A pilot study. Health Psychol Open, Jan-Jun 6(1):2055102919854667. https://doi.org/10.1177/2055102919854667

Donaldson, C., Baker, R., Mason, H., Jones-Lee, M., Lancsar, E., Wildman, J., ... & Prades, J. L. P. (2011). The social value of a QALY: raising the bar or barring the raise?. BMC health services research, 11(1), 1-8.


Douglas, R. S., Kahaly, G. J., Patel, A., Sile, S., Thompson, E. H., Perdok, R., ... & Antonelli, A. (2020). Teprotumumab for the treatment of active thyroid eye disease. New England Journal of Medicine, 382(4), 341-352. https://doi.org/10.1056/NEJMoa1910434

Dupuy, H. (1984). The Psychological General Well-Being (PGWB) Index. In Assess- ment of Quality of Life in Clinical Trials of Cardiovascular Therapies. M. Wengern N., M., Furberg, C., Elinson, J., ed. Pp. 170-183. New York: Le Jacq Publishing.

Egle, U. T., Kahaly, G. J., Petrak, F., Hardt, J., Batke, J., Best, J., & Rothenbacher, M. (1999). The relevance of physical and psychosocial factors for the quality of life in patients with thyroid-associated orbitopathy (TAO). Experimental and Clinical Endocrinology & Diabetes, 107(S 05), S168-S171.


Elberling, T. V., Rasmussen, A. K., Feldt-Rasmussen, U., Hording, M., Perrild, H., & Waldemar, G. (2004). Impaired health-related quality of life in Graves' disease. A prospective study. European Journal of Endocrinology, 151(5), 549-555. https://doi.org/10.1530/eje.0.1510549

Elkinton, J. R. (1966). Medicine and the quality of life. Annals of Internal Medicine, 64, 711-714.


Estcourt, S., Quinn, A. G., & Vaidya, B. (2011). Quality of life in thyroid eye disease: impact of quality of care. European Journal of Endocrinology, 164(5), 649. https://doi.org/10.1530/EJE-11-0055

Fallahi, P., Ferrari, S. M., Elia, G., Nasini, F., Colaci, M., Giuggioli, D., ... & Antonelli, A. (2016). Novel therapies for thyroid autoimmune diseases. Expert Review of Clinical Pharmacology, 9(6), 853-861.


Fardella, C. E., Gloger, S., Figueroa, R., Santis, R., Gajardo, C., Salgado, C., ... & Foradori, A. (2000). High prevalence of thyroid abnormalities in a Chilean psychiatric outpatient population. Journal of Endocrinological Investigation, 23(2), 102-106. https://doi.org/10.1007/BF03343687

Fabio, R.A., Martino, G., Caprì, T., Giacchero, R., Giannatiempo, S., Antonietti, A., Banderali, G., Canevini, M.P., Vignoli, A. (2018a). Long chain poly-unsatured fatty acid supplementation in Rett syndrome: a randomized placebo-controlled trial. Asian Journal of Clinical Nutrition, 10(1), 37-46.


Fabio, R. A., Caprì, T., Lotan, M., Towey, G. E., & Martino, G. (2018). Motor abilities are related to the specific genotype in Rett Syndrome. Advances in genetics research, 18, 79-108.

Farid, M., Roch-Levecq, A. C., Levi, L., Brody, B. L., Granet, D. B., & Kikkawa, D. O. (2005). Psychological disturbance in graves ophthalmopathy. Archives of Ophthalmology, 123(4), 491-496.


Ferløv-Schwensen, C., Brix, T. H., & Hegedüs, L. (2017). Death by suicide in Graves' disease and Graves' orbitopathy: A nationwide Danish register study. Thyroid, 27(12), 1475-1480.


Ferrari, S. M., Fallahi, P., Vita, R., Antonelli, A., & Benvenga, S. (2015). Peroxisome proliferator-activated receptor-γ in thyroid autoimmunity. PPAR research, 2015. https://doi.org/10.1155/2015/232818

Gerding, M. N., Terwee, C. B., Dekker, F. W., Koornneef, L., Prummel, M. F., & Wiersinga, W. M. (1997). Quality of life in patients with Graves' ophthalmopathy is markedly decreased: measurement by the medical outcomes study instrument. Thyroid, 7(6), 885-889. https://doi.org/10.1089/thy.1997.7.885

Grabe, H. J., Völzke, H., Lüdemann, J., Wolff, B., Schwahn, C., John, U., ... & Freyberger, H. J. (2005). Mental and physical complaints in thyroid disorders in the general population. Acta Psychiatrica Scandinavica, 112(4), 286-293. https://doi.org/10.1111/j.1600-0447.2005.00586.x

Graham, C.D., Rose, M.R., & Simmons, Z. (2012). Quality of life and measures of quality of life in patients with neuromuscular disorders. Muscle & Nerve, 46, 9–25. https://doi.org/10.1002/mus.23245

Guicciardi, M., Crisafulli, A., Doneddu, A., Fadda, D., and Lecis, R. (2019). Effects of metabolic syndrome on cognitive performance of adults during exercise. Frontiers in Psychology, 10,1845.


Gulseren, S., Gulseren, L., Hekimsoy, Z., Cetinay, P., Ozen, C., & Tokatlioglu, B. (2006). Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Archives of Medical Research, 37(1), 133-139. https://doi.org/10.1016/j.arcmed.2005.05.008

Iacobæus, L., & Sahlin, S. (2016). Evaluation of quality of life in patients with Graves ophthalmopathy, before and after orbital decompression. Orbit, 35(3), 121-125. https://doi.org/10.1080/01676830.2016.1176049

Jenkinson, C., Coulter, A., & Wright, L. (1993). Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. Bmj, 306(6890), 1437-1440. https://doi.org/10.1136/bmj.306.6890.1437

Kahaly, G. J., Hardt, J., Petrak, F., & Egle, U. T. (2002). Psychosocial factors in subjects with thyroid-associated ophthalmopathy. Thyroid, 12(3), 237-239. https://doi.org/10.1089/105072502753600205

Kahaly, G. J., Petrak, F., Hardt, J., Pitz, S., & Egle, U. T. (2005). Psychosocial morbidity of Graves’ orbitopathy. Clinical Endocrinology, 63(4), 395-402. https://doi.org/10.1111/j.1365-2265.2005.02352.x

Kathol, R. G., & Delahunt, J. W. (1986). The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria. General Hospital Psychiatry, 8(1), 23-28.


Kim, Y. A., Cho, S. W., Choi, H. S., Moon, S., Moon, J. H., Kim, K. W., ... & Cho, B. Y. (2017). The second antithyroid drug treatment is effective in relapsed Graves' disease patients: a median 11-year follow-up study. Thyroid, 27(4), 491-496. https://doi.org/10.1089/thy.2016.0056

Landgraf, J. M., Maunsell, E., Speechley, K. N., Bullinger, M., Campbell, S., Abetz, L., & Ware, J. E. (1998). Canadian-French, German and UK versions of the Child Health Questionnaire: methodology and preliminary item scaling results. Quality of Life Research, 7(5), 433-445.


Lee, H., Roh, H. S., Yoon, J. S., & Lee, S. Y. (2010). Assessment of quality of life and depression in Korean patients with Graves' ophthalmopathy. Korean Journal of Ophthalmology, 24(2), 65-72.


Lenzo, V., Sardella, A., Martino, G., Quattropani, M.C. (2020). A systematic review of metacognitive beliefs in chronic medical conditions. Frontiers in Psychology, 10: 2875. https://doi.org/10.3389/fpsyg.2019.02875

Ljunggren, J. G., Törring, O., Wallin, G., Taube, A., Tallstedt, L., Hamberger, B., & Lundell, G. (1998). Quality of life aspects and costs in treatment of Graves' hyperthyroidism with antithyroid drugs, surgery, or radioiodine: results from a prospective, randomized study. Thyroid, 8(8), 653-659.


Marchetti, D., Carrozzino, D., Fraticelli, F., Fulcheri, M., & Vitacolonna, E. (2017). Quality of life in women with gestational diabetes mellitus: a systematic review. Journal of diabetes research, 2017. https://doi.org/10.1155/2017/7058082

Marchini, F., Caputo, A., Napoli, A., Tan Balonan, J., Martino, G., Nannini, V., & Langher, V. (2018). Chronic Illness as Loss of Good Self: Underlying Mechanisms Affecting Diabetes Adaptation. Mediterranean Journal of Clinical Psychology, 6(3). https://doi.org/10.6092/2282-1619/2018.6.1981

Marcocci, C., Kahaly, G. J., Krassas, G. E., Bartalena, L., Prummel, M., Stahl, M., ... & Sivelli, P. (2011). Selenium and the course of mild Graves' orbitopathy. New England Journal of Medicine, 364(20), 1920-1931.


Martino, G., Catalano, A., Bellone, F., Langher V., Lasco C., Penna, A., Nicocia G., Morabito N. (2018). Quality of life in postmenopausal women: which role for vitamin D? Mediterranean Journal of Clinical Psychology, 6(2), 1-14. https://doi.org/10.6092/2282-1619/2018.6.1875

Martino, G., Caputo, A., Bellone, F., Quattropani, M. C., & Vicario, C. M. (2020a). Going Beyond the Visible in Type 2 Diabetes Mellitus: Defense Mechanisms and their Associations with Depression and Health-Related Quality of Life. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2020.00267

Martino, G., Bellone, F., Langher, V., Caputo, A., Catalano, A., Quattropani, M. C.,et al. (2019a). Alexithymia and psychological distress affect perceived quality of life in patients with Type 2 diabetes mellitus. Mediterranean Journal of Clinical Psychology, 7, 1–15. https://doi.org/10.6092/2282-1619/2019.7.2328

Martino, G., Caputo, A., Schwarz, P., Fries, W., Bellone, F., Quattropani, M. C., & Vicario, C. M. (2020b). Alexithymia and Inflammatory Bowel Disease: a Systematic Review. Frontiers in Psychology, 11, 1763. 10.3389/fpsyg.2020.01763

Martino, G., Caputo, A., Vicario, C.M., Catalano, A., Schwarz, P., Quattropani, M.C. (2020c). The Relationship Between Alexithymia and Type 2 Diabetes: a Systematic Review. Frontiers in Psychology, 11. 10.3389/fpsyg.2020.02026

Martino, G., Catalano, A., Agostino, R. M., Bellone, F., Morabito, N., Lasco, C. G., ... & Feldt-Rasmussen, U. (2020d). Quality of life and psychological functioning in postmenopausal women undergoing aromatase inhibitor treatment for early breast cancer. PloS One, 15(3), e0230681.


Martino, G., Catalano, A., Bellone, F., Russo, G. T., Vicario, C. M., Lasco, A., et al. (2019b). As time goes by: anxiety negatively affects the perceived quality of life in patients with Type 2 diabetes of long duration. Frontiers in Psychology, 10, 1779. https://doi.org/10.3389/fpsyg.2019.01779

Martino, G., Langher, V., Cazzato, V., & Vicario, C.M. (2019c). Editorial: Psychological Factors as Determinants of Medical Conditions. Frontiers in Psychology, 10, 2502.


Matos‐Santos, A., Nobre, E. L., Costa, J. G. E., Nogueira, P. J., Macedo, A., Galvão‐Teles, A., & De Castro, J. J. (2001). Relationship between the number and impact of stressful life events and the onset of Graves' disease and toxic nodular goitre. Clinical Endocrinology, 55(1), 15-19.


Merlo, E. M. (2019a). Adolescent phobia as a “mask object”. Mediterranean Journal of Clinical Psychology, 7(1).


Merlo, E. M. (2019b). Opinion article: the role of psychological features in chronic diseases, advances and perspectives. Mediterranean Journal of Clinical Psychology, 7, 1–6. 10. https://doi.org/10.6092/2282-1619/2019.7.2341

Motofei, I. G., Rowland, D. L., Popa, F., Bratucu, E., Straja, D., Manea, M., ... & Constantin, V. D. (2015). A pilot study on tamoxifen sexual side effects and hand preference in male breast cancer. Archives of sexual behavior, 44(6), 1589-1594. https://doi.org/10.1007/s10508-015-0530-4

Nexo, M. A., Watt, T., Pedersen, J., Bonnema, S. J., Hegedüs, L., Rasmussen, A. K., ... & Bjorner, J. B. (2014). Increased risk of long-term sickness absence, lower rate of return to work, and higher risk of unemployment and disability pensioning for thyroid patients: a Danish register-based cohort study. The Journal of Clinical Endocrinology & Metabolism, 99(9), 3184-3192. https://doi.org/10.1210/jc.2013-4468

Park, J. J., Sullivan, T. J., Mortimer, R. H., Wagenaar, M., & Perry-Keene, D. A. (2004). Assessing quality of life in Australian patients with Graves’ ophthalmopathy. British Journal of Ophthalmology, 88(1), 75-78.


Perros, P., & Wiersinga, W. M. (2010). The Amsterdam Declaration on Graves' orbitopathy. Thyroid : official journal of the American Thyroid Association, 20(3), 245–246. https://doi.org/10.1089/thy.2010.1618

Perros P, In Wiersinga WM, Kahaly GJ (eds) (2017): Graves’ Orbitopathy: A Multidisciplinary Approach – Questions and Answers, Basel, Karger Publisher. https://doi.org/10.1159/isbn.978-3-318-06085-0

Ponto, K. A., Merkesdal, S., Hommel, G., Pitz, S., Pfeiffer, N., & Kahaly, G. J. (2013). Public health relevance of Graves' orbitopathy. The Journal of Clinical Endocrinology & Metabolism, 98(1), 145-152.


Ponto, K. A., Hommel, G., Pitz, S., Elflein, H., Pfeiffer, N., & Kahaly, G. J. (2011). Quality of life in a german graves orbitopathy population. American journal of ophthalmology, 152(3), 483–490.e1.


Porcerelli, J. H., Cramer, P., Porcerelli, D. J., & Arterbery, V. E. (2017). Defense Mechanisms and Utilization in Cancer Patients Undergoing Radiation Therapy. A Pilot Study. Journal of Nervous and Mental Disease, 205, 466-470. https://doi.org/10.1097/NMD.0000000000000674

Revicki, D. A., Osoba, D., Fairclough, D., Barofsky, I., Berzon, R., Leidy, N. K., & Rothman, M. (2000). Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Quality of Life Research, 9(8), 887-900. https://doi.org/10.1023/A:1008996223999

Rieben, C., Segna, D., da Costa, B. R., Collet, T. H., Chaker, L., Aubert, C. E., ... & Masaki, K. (2016). Subclinical thyroid dysfunction and the risk of cognitive decline: a meta-analysis of prospective cohort studies. The Journal of Clinical Endocrinology & Metabolism, 101(12), 4945-4954.


Riguetto, C. M., Neto, A. M., Tambascia, M. A., & Zantut-Wittmann, D. E. (2019). The relationship between quality of life, cognition, and thyroid status in Graves’ disease. Endocrine, 63(1), 87-93.


Rosa, V., Tomai, M., Lauriola, M., Martino, G., & Di Trani, M. (2019). Body mass index, personality traits, and body image in Italian pre-adolescents: An opportunity for overweight prevention. Psihologija, 9(10.2298). ISSN: 00485705. https://doi.org/10.2298/PSI181121009R

Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., ... & Walter, M. A. (2016). 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid, 26(10), 1343-1421. https://doi.org/10.1089/thy.2016.0229

Samuels, M. H. (2008). Cognitive function in untreated hypothyroidism and hyperthyroidism. Current Opinion in Endocrinology, Diabetes and Obesity, 15(5), 429-433. https://doi.org/10.1097/MED.0b013e32830eb84c

Settineri, S., Frisone, F., Alibrandi, A., & Merlo, E. M. (2019a). Emotional suppression and oneiric expression in psychosomatic disorders: early manifestations in emerging adulthood and young patients. Frontiers in psychology, 10, 1897. https://doi.org/10.3389/fpsyg.2019.01897

Settineri, S., Frisone, F., Merlo, E. M., Geraci, D., & Martino, G. (2019b). Compliance, adherence, concordance, empowerment, and self-management: five words to manifest a relational maladjustment in diabetes. J. Multidiscipl. Healthc. 12:299. https://doi.org/10.2147/JMDH.S193752

Sjölin, G., Holmberg, M., Törring, O., Byström, K., Khamisi, S., de Laval, D., ... & Filipsson Nyström, H. (2019). The long-term outcome of treatment for Graves' hyperthyroidism. Thyroid, 29(11), 1545-1557.


Smith, T. J., Kahaly, G. J., Ezra, D. G., Fleming, J. C., Dailey, R. A., Tang, R. A., ... & Gigantelli, J. W. (2017). Teprotumumab for thyroid-associated ophthalmopathy. New England Journal of Medicine, 376(18), 1748-1761.


Stewart, A. L., Hays, R. D., & Ware, J. E. (1988). The MOS short-form general health survey: reliability and validity in a patient population. Medical Care, 26(7), 724-735. https://doi.org/10.1097/00005650-198807000-00007

Stone, A., Shiffman, S., Atienza, A., & Nebeling, L. (2007). The science of real-time data capture: Self-reports in health research. Oxford University Press.

Tagami, T., Yambe, Y., Tanaka, T., Tanaka, T., Ogo, A., Yoshizumi, H., ... & Usui, T. (2012). Short-term effects of β-adrenergic antagonists and methimazole in new-onset thyrotoxicosis caused by Graves' disease. Internal Medicine, 51(17), 2285-2290. https://doi.org/10.2169/internalmedicine.51.7302

Terwee, C., Wakelkamp, I., Tan, S., Dekker, F., Prummel, M. F., & Wiersinga, W. (2002). Long-term effects of Graves' ophthalmopathy on health-related quality of life. European Journal of Endocrinology, 146(6), 751-757. https://doi.org/10.1530/eje.0.1460751

Terwee, C. B., Dekker, F. W., Mourits, M., Gerding, M. N., Baldeschi, L., Kalmann, R., ... & Wiersinga, W. M. (2001). Interpretation and validity of changes in scores on the Graves' ophthalmopathy quality of life questionnaire (GO‐QOL) after different treatments. Clinical Endocrinology, 54(3), 391-398.


Terwee, C. B., Gerding, M. N., Dekker, F. W., Prummel, M. F., & Wiersinga, W. M. (1998). Development of a disease specific quality of life questionnaire for patients with Graves’ ophthalmopathy: the GO-QOL. British Journal of Ophthalmology, 82(7), 773-779. https://doi.org/10.1136/bjo.82.7.773

Testa, M. A., & Simonson, D. C. (1996). Assessment of quality-of-life outcomes. New England journal of medicine, 334(13), 835-840. https://doi.org/10.1056/NEJM199603283341306

Tomai, M., & Lauriola, M., & Caputo, A. (2018). Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages?. Mediterranean Journal of Clinical Psychology, 7(1). https://doi.org/10.6092/2282-1619/2019.7.1983

Topcu, C. B., Celik, O., & Tasan, E. (2012). Effect of stressful life events on the initiation of graves’ disease. International Journal of Psychiatry in Clinical Practice, 16(4), 307-311.


Törring, O., Watt, T., Sjölin, G., Byström, K., Abraham-Nordling, M., Calissendorff, J., ... & Khamisi, S. (2019). Impaired quality of life after radioiodine therapy compared to antithyroid drugs or surgical treatment for Graves' hyperthyroidism: a long-term follow-up with the thyroid-related patient-reported outcome questionnaire and 36-item short form health status survey. Thyroid, 29(3), 322-331.


Trzepacz, P. T., McCue, M., Klein, I., Levey, G. S., & Greenhouse, J. (1988). A psychiatric and neuropsychological study of patients with untreated Graves' disease. General Hospital Psychiatry, 10(1), 49-55.


Verrocchio, M. C., Marchetti, D., Carrozzino, D., Compare, A., & Fulcheri, M. (2019). Depression and quality of life in adults perceiving exposure to parental alienation behaviors. Health and Quality of Life Outcomes, 17(1), 14. https://doi.org/10.1186/s12955-019-1080-6

Vicario, C. M., & Martino, G. (2020). Dopamine and serotonin in fear extinction: some key questions to be addressed. AIMS Neuroscience, 7(3): 271-274. https://doi.org/10.3934/Neuroscience.2020014

Vicario, C. M., Nitsche, M. A., Salehienjad, M. A., Avanzino, L., & Martino, G. (2020). Time processing, interoception and insula activation: a mini review on clinical disorders. Frontiers in Psychology, 11, 1893. 10.3389/fpsyg.2020.01893

Villagelin, D., Romaldini, J., Andrade, J., Santos, R., Milkos, A., dos Santos Teixeira, P. F., & Ward, L. S. (2019). Evaluation of Quality of Life in the Brazilian Graves' Disease Population: Focus on Mild and Moderate Graves' Orbitopathy Patients. Frontiers in Endocrinology, 10.


Vita, R., Di Bari, F., Perelli, S., Capodicasa, G., & Benvenga, S. (2019). Thyroid vascularization is an important ultrasonographic parameter in untreated Graves’ disease patients. Journal of Clinical & Translational Endocrinology, 15, 65-69. https://doi.org/10.1016/j.jcte.2019.01.001

Vita, R., Lapa, D., Trimarchi, F., & Benvenga, S. (2015). Stress triggers the onset and the recurrences of hyperthyroidism in patients with Graves’ disease. Endocrine, 48(1), 254-263.


Vita, R., Lapa, D., Trimarchi, F., Vita, G., Fallahi, P., Antonelli, A., & Benvenga, S. (2017). Certain HLA alleles are associated with stress-triggered Graves’ disease and influence its course. Endocrine, 55(1), 93-100.


Vita, R., Lapa, D., Vita, G., Trimarchi, F., & Benvenga, S. (2009). A patient with stress-related onset and exacerbations of Graves’ disease. Nature Clinical Practice Endocrinology & Metabolism, 5(1), 55-61.


Vita, R., Mazzi, V., Antonelli, A., Benvenga, S. (2013). Antithyroid medications and psychosis. Expert Opinion on Drug Safety, 12(6):865-72. https://doi.org/10.1517/14740338.2013.823397

Ware, J.E., Kosinski, M., Keller, S.D. (1995). SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales. Boston, MA: The Health Institute, New England Medical Center, Second Edition.

Watt, T., Bjorner, J. B., Groenvold, M., Cramon, P., Winther, K. H., Hegedüs, L., ... & Feldt-Rasmussen, U. (2015). Development of a short version of the thyroid-related patient-reported outcome ThyPRO. Thyroid, 25(10), 1069-1079. https://doi.org/10.1089/thy.2015.0209

Watt, T., Bjorner, J. B., Groenvold, M., Rasmussen, Å. K., Bonnema, S. J., Hegedüs, L., & Feldt-Rasmussen, U. (2009). Establishing construct validity for the thyroid-specific patient reported outcome measure (ThyPRO): an initial examination. Quality of Life Research, 18(4), 483-496.


Watt, T., Cramon, P., Hegedüs, L., Bjorner, J. B., Bonnema, S. J., Rasmussen, Å. K., ... & Groenvold, M. (2014). The thyroid-related quality of life measure ThyPRO has good responsiveness and ability to detect relevant treatment effects. The Journal of Clinical Endocrinology & Metabolism, 99(10), 3708-3717.


Weng, C. Y., Li, Z. F., Hu, S. D., Luo, Y. S., Feng, X. T., Zhong, Q., ... & Shen, J. (2019). Evaluation of quality of life in patients with Graves orbitopathy and its influencing factors. Zhonghua nei ke za zhi, 58(8), 577-583.

Wiersinga, W. M. (2012). Quality of life in Graves’ ophthalmopathy. Best Practice & Research Clinical Endocrinology & Metabolism, 26(3), 359-370. https://doi.org/10.1016/j.beem.2011.11.001

Wong, C. K., Lang, B. H., & Lam, C. L. (2016). A systematic review of quality of thyroid-specific health-related quality-of-life instruments recommends ThyPRO for patients with benign thyroid diseases. Journal of Clinical Epidemiology, 78, 63-72. https://doi.org/10.1016/j.jclinepi.2016.03.006

Wong, C. K., Choi, E. P., Woo, Y. C., & Lang, B. H. (2018). Measurement properties of ThyPRO short-form (ThyPRO-39) for use in Chinese patients with benign thyroid diseases. Quality of Life Research, 27(8), 2177-2187. https://doi.org/10.1007/s11136-018-1857-9

Zimmerman, T. N., Porcerelli, J. H., & Arterbery, V. E. (2019). Defensive functioning in cancer patients, cancer survivors, and controls. Psychoanalytic Psychology, 36, 259-262.


DOI: https://doi.org/10.6092/2282-1619/mjcp-2521


  • There are currently no refbacks.