Risk factors of anxiety and depression in patients undergoing surgery for thyroid cancer
Abstract
Background: Postoperative patients with thyroid cancer are prone to anxiety and depression, which will have adverse effects on their postoperative recovery and quality of life. Objective: To explore the status of postoperative anxiety and depression in patients with thyroid cancer, and analyze the related influencing factors and their relationship with quality of life. Methods: This study employed a convenient sampling method to enroll 152 patients undergoing thyroid cancer surgery. During the first postoperative follow-up, a comprehensive assessment was conducted using standardized instruments: Demographic information questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and the quality of life core questionnaire (EORTC QLQ-C30) developed by the European Organization for Research and Treatment of Cancer. Binary logistic regression was used to analyze the risk factors, and Spearman correlation analysis was used to analyze the relationship between anxiety, depression and quality of life. Results: Among 152 patients, the incidence of anxiety was 41.4%, and the incidence of depression was 36.2%. Binary Logistics analysis showed that gender (OR = 4.453, 95%CI: 1.186–16.711), occupational status (OR = 0.394, 95%CI: 1.152–3.428), family monthly income (OR = 0.567, 95%CI: 0.245–0.816), risk of recurrence (OR = 2.333, 95%CI: 1.922–5.902), vocal hoarseness (OR = 3.533, 95%CI: 1.429–8.734) were independent risk factors for anxiety in postoperative patients with thyroid cancer. The risk of recurrence (OR = 1.437, 95%CI: 1.136–3.825) and vocal hoarseness (OR = 6.465, 95%CI: 2.432–17.185) are independent risk factors for depression in patients with thyroid cancer after surgery. The anxiety and depression scores of postoperative patients with thyroid cancer were significantly negatively correlated with general health status and five functional domains (physical function, role function, emotional function, cognitive function and social function), and significantly positively correlated with six separate items (shortness of breath, insomnia, loss of appetite, financial difficulties) and three symptom domains (fatigue, nausea and vomiting, pain). In the functional domain dimension, the correlation between emotional function and anxiety and depression was the most significant (r = −0.589, r = −0.551). In the dimension of symptoms, fatigue had the highest correlation with anxiety and depression (r = 0.732, r = 0.908). At the single item level, pain had the highest correlation with anxiety and depression (r = 0.484, r = 0.427). Conclusion: The anxiety and depression of patients with thyroid cancer surgery are related to female, occupational status, family monthly income, risk of disease recurrence and hoarseness, and these negative emotions have a significant adverse impact on the quality of life.
Copyright (c) 2026 Xiaojuan Zhao, Yongli Chen, Chunhua Zhu
This work is licensed under a Creative Commons Attribution 4.0 International License.
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