Exploring the mental health challenges of children with autoimmune thyroiditis

Autoimmune thyroid disease is a common autoimmune disorder affecting the pediatric age group with a wide array of clinical presentations. Psychiatric symptoms may occur in association with autoimmune thyroiditis. This area has scarcely been explored in the pediatric age group. This study aimed to describe the clinical and laboratory features of autoimmune thyroid disease and to assess their behavioral characteristics and health-related quality of life.

We retrospectively analyzed the records of 134 children up to the age of 18 years, who were following up in the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU) at Abo El Rish El-Mounira Children's Hospital, Kasr Al Ainy, Cairo University. Data collected from their medical records included clinical and laboratory parameters, including thyroid antibodies and thyroid ultrasound. Out of 134 patients' records, 47 consented to participating in a psychiatric evaluation. Data obtained from theses evaluations was compared to that of 50 healthy matched control subjects.

The median age of the study group was 9.38 with IQR (7.16-11.68) years at the initial presentation of the illness. Goiter was the most prevalent presenting symptom in 26.1% of the cohort. Most of them (48.5%) were on thyroid replacement therapy (levothyroxine). Forty-seven of the patients consented to participate in a psychiatric evaluation. The patients had higher emotional and behavioral conduct problems scores than the controls with median and IQR [6 (4-80 and 4 (2-5)] versus [3 (1-5) and 2 (1-4)] with significant p-values of < 0.001 and 0.001 respectively on Strengths and Difficulties Questionnaire (SDQ). Additionally, the cases had lower physical well-being with a median of 3.25 and IQR (2.25-4.25) than the controls with a median of 4 and IQR (3.5-4.5) with a p-value of 0.014 on the KINDLR-parents' version.

Autoimmune thyroid disorders affecting the pediatric population can lead to emotional and conduct problems. Also, it affected their quality of life as they showed lower physical well-being scores. This should encourage earlier and thorough assessment of their psychological status and prompt management.