Early-life adversity and negative emotional responses are associated with hashimoto's thyroiditis

Stress and negative emotional states may contribute to immune dysregulation and pro-inflammatory pathways, increasing vulnerability to autoimmunity and adversely affecting psychological well-being. Hashimoto's thyroiditis (HT) is frequently associated with psychological stress, although data remain limited.

We enrolled 268 female subjects aged 21-70 years, including 157 patients with HT and 111 age-matched healthy controls. Participants completed validated questionnaires assessing trait emotional intelligence (TEIQue-SF), perceived stress (PSM), coping strategies (CISS), and adverse childhood experiences (ACEs). Socio-demographic and clinical data were also collected. Group differences were analyzed, and multivariable logistic regression was performed to identify factors independently associated with HT.

Compared with controls, HT patients reported a greater number of ACEs (p = 0.001) and a higher perceived burden associated with these experiences (p = 0.001). A family history of autoimmune disease was more frequent among HT patients (p = 0.001), and both family history (p = 0.004) and ACEs (p = 0.015) were independently associated with HT. Patients also showed higher perceived stress (p = 0.001) and lower well-being (p = 0.020) and self-control (p = 0.007) than controls. In addition, to face stressful events, HT patients relied more on emotion-oriented coping (p = 0.004) indicating a greater reliance on maladaptive strategies, whereas controls predominantly adopted task-oriented coping strategies (p = 0.005).

HT patients exhibit increased psychological vulnerability characterized by early-life adversity, reduced emotional resources, maladaptive coping, and heightened stress. These findings support a potential role of psychosocial stress as an additional vulnerability factor acting on a genetically predisposed background.