PSYCHOSOCIAL FACTORS INFLUENCING THE SHORT-TERM OUTCOME OF ANTITHYROID DRUG-THERAPY IN GRAVES-DISEASE

Objective: Although psychological stress and smoking have been propose d as factors contributing to Graves' disease, their independent roles in the course of this disease have not been determined. We assessed th e association between the course of Graves' disease and psychosocial f actors by using multivariate analysis. Methods: We investigated the as sociation between the short-term outcome of Graves' disease (assessed 12 months after the beginning of antithyroid drug therapy) and stressf ul life events, daily hassles, smoking, drinking habits, coping skills , and social support (before and 6 months after beginning therapy) in 230 patients (182 women and 48 men) with newly diagnosed Graves' disea se, using a logistic regression model. Results: After adjustment for s moking, coping skills, and thyroid function, daily hassles scores in w omen at 6 months after beginning therapy were significantly associated with a hyperthyroid state 12 months after beginning therapy. The rela tive risk was 3.9 for women with higher daily hassles scores compared with women with lower daily hassles scores (95% confidence interval, 1 .1 to 13.2; p <.05). Smoking was not significantly associated with a h yperthyroid state 12 months after beginning therapy in either women or men. Conclusions: Chronic psychological stress is associated with the course of Graves' disease in women.