Health Anxiety and Its Relationship to Thyroid-Hormone-Suppression Therapy in Patients with Differentiated Thyroid Cancer

Simple Summary Differentiated thyroid cancer (DTC) has a good prognosis; however, patients often need lifelong follow up and face potentially chronic psychiatric problems, such as health anxiety. We investigated the relationship between health anxiety and TSH-suppression treatment, which many patients receive lifelong. The health anxiety was assessed by using the 14-item Short Health Anxiety Inventory (SHAI-14), which is scored 0-42; higher values indicate more health anxiety. Out of 146 patients with DTC, 24 (16%) had clinically significant health anxiety. Patients with TSH levels of 0.1-0.5 (mE/L) scored, on average, 3.28 points more (p-value 0.01) on the SHAI-14 compared to patients with TSH levels > 0.5. We found that health anxiety appears to be slightly more common among DTC patients compared to the general population, but this was not clearly connected to the TSH-suppression treatment. Differentiated thyroid cancer (DTC) has a good prognosis; however, patients often need lifelong follow up, and they face potential side effects. The aim of this study was to investigate health anxiety among DTC patients and its relationship to TSH suppression. In 2020, patients from a previous cohort who were from Stockholm completed the 14-item Short Health Anxiety Inventory (SHAI-14; 0-42; 18 being the threshold for clinical significance) and a study-specific questionnaire. Clinical information was also retrieved from medical records. Linear regression was used to investigate the relationship between the TSH levels and the SHAI-14, while adjusting for potential confounders. In total, 146 (73%) patients were included. A total of 24 respondents (16%) scored 18 or more on the SHAI-14, and the mean score was 11.3. Patients with TSH levels of 0.1-0.5 (mE/L) scored, on average, 3.28 points more (p-value 0.01) on the SHAI-14 compared to patients with TSH levels > 0.5. There was no statistically significant difference between patients with TSH levels < 0.1 and TSH levels > 0.5. Thus, we found no linear relationship between the TSH values and health anxiety. Clinically significant levels of health anxiety are slightly higher than those in the general population, but do not appear to be a major psychiatric comorbidity among patients with DTC.