Temperament Traits and Psychiatric Vulnerability in Patients with Hypothyroidism: Modulators of Depression and Anxiety

Research Article

Abstract

Objective: To examine the moderating effects of temperament traits assessed by TEMPS-A on depressive and anxiety symptoms in adults with hypothyroidism and to explore their potential relevance for personalized treatment approaches.

Methods: This cross-sectional, observational, comparative study was conducted at Balıkesir Atatürk City Hospital and included 200 participants aged 18–65 years (hypothyroidism: n=100; age-, sex-, and education-matched healthy controls: n=100). Depression and anxiety were evaluated using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Temperament traits were assessed with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Group comparisons were performed using Student’s t-test or Mann–Whitney U test and Chi-square test as appropriate. Associations were analyzed using Spearman correlation, and predictors of psychiatric symptoms were examined with multivariate linear regression models. Statistical significance was set at p<0.05.

Results: The groups were comparable in age and sex (mean age: 40.9 ± 12.4 years; p>0.05). The hypothyroidism group demonstrated significantly higher anxiety levels (BAI: U=8141.0, p<0.001), with moderate-to-severe anxiety in 42% versus 15% of controls. Depression scores were also higher in the hypothyroidism group (BDI: U=6673.0, p=0.0001), with moderate-to-severe depression observed in 48% compared with 17% of controls. TEMPS-A temperament profiles did not differ significantly between groups (U=5100.5, p=1.000). No significant correlation was observed between anxiety and temperament scores, while a weak, non-significant association was noted between depression and temperament. Multivariate analyses indicated that thyroid status was the primary predictor of psychiatric symptoms, with limited additional contribution from temperament traits.

Conclusion: Individuals with hypothyroidism exhibit significantly higher levels of depression and anxiety than healthy controls. While temperament traits showed minimal explanatory value, temperament-sensitive interventions alongside hormonal management may support personalized clinical care. Longitudinal studies with interaction-term models are warranted.