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Cognitive function, anxiety, and depression in patients newly diagnosed with thyroid cancer in China
TaiXu Jiang1, HongShi Shi1, YueNan Zheng1
1Department of Thyroid, Breast and Hernia Surgery, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, China.
Background:
Despite excellent prognosis, cognitive and emotional disturbances have been reported in survivors of differentiated thyroid cancer (DTC). However, few studies in China have described baseline cognitive and emotional status in patients with newly diagnosed DTC prior to treatment.
Objective:
To investigate possible cognitive impairment as well as anxiety and depression levels in patients newly diagnosed with DTC before treatment, and to explore their associated factors, so as to provide baseline data regarding cognitive and emotional disturbances among Chinese patients with DTC.
Methods:
This cross-sectional study enrolled patients with DTC treated at a tertiary referral hospital between July and September 2023. Participants completed the Montreal Cognitive Assessment (MoCA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS). Chi-square tests were used for intergroup comparisons, while univariate and multivariate logistic regression analyses were performed to explore factors associated with possible cognitive impairment, anxiety, and depression.
Results:
A total of 708 preoperative patients with newly diagnosed DTC were enrolled. Among them, 7.2% presented anxiety symptoms, 20.3% presented depression symptoms, and 62.7% exhibited possible cognitive impairment. Among female participants, postmenopausal status was associated with possible cognitive impairment. Multivariate logistic regression showed that age (p = 0.003) and educational levels (p < 0.05) were independent correlates of possible cognitive impairment among women, while age (p < 0.001), work status (p < 0.05) and residence (p = 0.007) were independently correlated with possible cognitive impairment in the overall cohort. Elevated TSH was a correlate of anxiety (p = 0.014). Income status was independently associated with depressive symptoms (p < 0.05).
Conclusion:
Psychological and cognitive disturbances are common among preoperative with DTC. Age, postmenopausal status, educational levels, work status, and residence are related to possible cognitive impairment. TSH levels are relevant correlates of anxiety, and income status is correlated with depression. Routine psychological and cognitive screening should be considered for preoperative DTC patients.