PHQ-9 and GAD-7 Score Response After Parathyroidectomy for Primary Hyperparathyroidism: a Systematic Review and...

Area of Science:

• Endocrinology
• Neurosurgery
• Psychiatry

Background:

• Primary hyperparathyroidism (PHPT) is linked to neuropsychiatric symptoms.
• The impact of parathyroidectomy on these symptoms requires further definition.

Purpose of the Study:

• To conduct the first meta-analysis on preoperative and postoperative PHQ-9 and GAD-7 scores in PHPT patients undergoing parathyroidectomy.
• To identify a psychometric score that could guide surgical intervention decisions.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Embase, PsycINFO, Web of Science, Ovid).
• Included studies evaluated PHQ-9 and/or GAD-7 scores pre- and post-parathyroidectomy in PHPT patients.
• Random effects meta-analyses were performed on the compiled data.

Main Results:

• Six studies (1105 participants) met inclusion criteria.
• PHPT patients exhibited higher presurgical PHQ-9 scores compared to controls.
• Parathyroidectomy led to a significant and sustained decrease in PHQ-9 scores, with a notable reduction in clinically significant depression scores (≥10).

Conclusions:

• Parathyroidectomy results in significant, sustained improvement in depression scores (PHQ-9) for PHPT patients.
• Anxiety and suicidal ideation symptoms also appear to decrease post-surgery.
• A PHQ-9 score ≥10 may serve as a potential surgical indication for asymptomatic PHPT.