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The journal «ONCOSURGERY» 2013, Vol.5, No 4

Psychological characteristics of patient with nodal lesions in thyroid gland

Velsher LZ1, Averyanova SV2, Bardenstein LM1

1) Moscow State Medical Stomatological University of Russian Federation Health Care, Moscow, Russia
2) Railway Clinical Hospital, JSCo «RZD», Saratov, Russia
Contact: Averyanova SV, e-mail:

The article reviews personal characteristics with thyroid cancer versus patients with nodal lesions in thyroid gland in pre- and post-operative periods.

Material and methods. 45 women with nodal lesions in thyroid gland in uethyroid status were examined. 20 women (average age – 52.9±9.9 years) had malignant thyroid lesions (group 1); according to histological study they had: papillary cancer – in 11, follicular cancer – in 7, medullary cancer – in 2 patients. 25 women (average age – 50.2±10.5 years) with benign tumors: follicular adenoma – in 10, multy-nodal colloid goiter – in 15 patients were included into group 2. The shortform of Minnesota Multiphasic Personality Inventory (MMPI) test was used for identifying personal characteristics. Patients were tested the day before surgery and 1 week after surgery.

Results. For group 1 «linear» profile indicating balanced personal development occurred only in one patient; for group one this profile occurred almost in quarter of patients. More than the half of patients with thyroid cancer had different accentuation of personality traits, in group 2 the accentuation occurred less frequently (р=036). In 6 patients of group 1 and in 9 patients of group 2 negation of disease developed as protective response followed by increase of scores on Hypomania scale.

In patients with cancer the increase of scores on «neurotic triad» scales occurred in the half of patients, the majority of them (8 of 10) had «conversional quinary» characterizing transformation of neurotic anxiety to functional physical disease. In 7 patients with «conversional V» increase of scores on scale 3 more than 70 T-scores represented the hysterical type of maladjustment. For group 1 two patients had neurosis-like profile and 1 patient had a profile of «free-floating anxiety» requiring drug treatment.

In group 2 increase of scores on «neurotic triad» scales occurred in 36% of patients (9 of 25), 7 of them had simultaneous increase on Hypochondriasis and Hysteria with development of «conversional V». Increase of scores on scale 3 representing the presence of hysterical response occurred significantly less frequent than in the group 1 (р=03). Neurosis-like profile was in 3 patients with benign nodal thyroid lesions, there were no profile of «free-floating anxiety» in this group.

The increase of scores on Depression scale occurred in 2 women of group 1 and in 4 patients of group 2, scores higher than 70 Т-scores occurred in 1 patient from each group. High scores on Paranoia scale were in nearly equal numbers of patients from each group – 40% and 45%, respectively. Peak on Psychasthenia scale occurred significantly rarer.

Conclusion. Balanced personality configuration was in 24% of patients with benign thyroid nodal lesions and in 5% of women with thyroid cancer. Accentuated personalities occurred significantly more frequently in women with thyroid cancer comparing with those with benign nodal lesions. Hysterical accentuation was the most frequent. The most common protective response in patients with both benign and malignant nodal lesions was negation of disease – in 36% and 30%, respectively. Depressive response in patients with thyroid nodal lesions occurred relatively rare: 16% for benign lesions and 10% – for thyroid cancer. Personality-oriented methods for rehabilitation of patients with thyroid nodal lesions are required.

KEY WORDS: thyroid cancer, nodal goiter, personality profile, depression, accentuation.

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