Risk of psychiatric disorders in patients with graves' disease: A nationwide population-based analysis

Abstract

Background: Graves' disease (GD) is an autoimmune hyperthyroidism and is associated with various psychiatric symptoms, such as irritability, mood changes, and insomnia. However, the epidemiological risk of psychiatric disorders among individuals with GD remains unclear. This study aimed to investigate whether a diagnosis of GD is associated with an increased incidence of various psychiatric disorders at a nationwide level. Methods: This study was a retrospective cohort study using data from the Korean National Health Insurance Claims database. We identified 20,851 patients with newly diagnosed GD and 46,008 age- and sex-matched controls. Cox proportional hazards models were used to estimate the risk of incident psychiatric disorders in patients with GD compared to controls. We further analyzed the hazard ratios (HRs) by follow-up period (<2 years, ≥2 years) since the diagnosis of GD. Results: Patients with GD exhibited a higher risk of developing psychiatric disorders compared to controls. The risk for incident depression (HR: 1.34, 95 % CI: 1.24–1.44), bipolar disorder (HR: 1.57, 95 % CI: 1.31–1.89), anxiety disorder (HR: 1.52, 95 % CI: 1.43–1.63), and sleep disorder (HR: 1.44, 95 % CI: 1.32–1.58) was significantly elevated. This increased risk for various psychiatric disorders, except schizophrenia, persisted even two years after the GD diagnosis. The association between GD and schizophrenia was not statistically significant. Conclusions: This large-scale, population-based study demonstrates a significant association between GD and an increased risk of developing depression, bipolar disorder, anxiety disorder, and sleep disorder. The findings underscore the importance of long-term monitoring for psychiatric disorders in patients with GD.