Hypothyroidism and type d personality:Results from E-MPATHY, a cross-sectional international online patient survey

ContextBetween 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving biochemical euthyroidism.The underlying causes are unclear. Type D personality (a vulnerability factor for general psychological distress) is associated with poor healthstatus and symptom burden but has not been studied in people with hypothyroidism.ObjectiveTo investigate type D personality in hypothyroidism and explore associations with other characteristics and patient-reported outcomes.DesignMultinational, cross-sectional survey.SettingOnline.ParticipantsIndividuals with self-reported, treated hypothyroidism.InterventionQuestionnaire.Main Outcome MeasuresType D personality and associations with baseline characteristics, control of the symptoms of hypothyroidism bymedication, satisfaction with care and treatment of hypothyroidism, impact of hypothyroidism on everyday living.ResultsA total of 3915 responses were received, 3523 of which were valid. The prevalence of type D personality was 54.2%. Statisticallysignificant associations were found between type D personality and several respondent characteristics (age, marital status, ethnicity,household income, comorbidities, type of treatment for hypothyroidism, most recent TSH level), anxiety, depression, somatization, poorcontrol of the symptoms of hypothyroidism by medication, dissatisfaction with care and treatment of hypothyroidism, and a negative impactof hypothyroidism on everyday living).DiscussionOur study found a high prevalence of type D personality among people with hypothyroidism who responded to the survey. Type Dpersonality may be an important determinant of dissatisfaction with treatment and care among people with hypothyroidism. Our findings requireindependent confirmation. Close collaboration between the disciplines of thyroidology and psychology is likely to be key in progressing ourunderstanding in this area