This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on Web of Science (10)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Otolaryngology/ Head & Neck Surgery  • Psychiatry  • Stress  • Alert me on articles by topic  Social Bookmarking   What's this?

Takahiro Okamoto, MD, MSc; Toshiko Kamo, MD, PhD; Takao Obara, MD, PhD

Arch Surg. 2002;137:779-783.

Background  Primary hyperparathyroidism is a common endocrinopathy. The appropriate management of its mild form, however, remains controversial.

Hypothesis  Mild primary hyperparathyroidism is associated with psychological distress and other nonspecific symptoms that improve following parathyroidectomy.

Design  Two-year prospective before-after study.

Setting  University hospital.

Patients  Twenty-six consecutive patients with mild hypercalcemia (<12 mg/dL [<3 mmol/L]) due to primary hyperparathyroidism, without osteitis fibrosa cystica or urolithiasis were enrolled from January 11, 1997, through April 21, 1998.

Intervention  Parathyroidectomy.

Main Outcome Measures  Primary outcome was psychological distress as measured by the 28-item version of the General Health Questionnaire. Secondary outcomes included body weight, joint pain, and occurrences of bowel movements and urination.

Results  Before surgery, 15 patients (58%; 95% confidence interval, 37%-77%) showed psychological distress (case group) while 11 patients did not (noncase group). A clinically and statistically significant reduction in the General Health Questionnaire score was detected at 3 months in the case group (-6.1; 95% confidence interval, -11.0 to -1.2), but the reduction was smaller (-1.9; 95% confidence interval, -6.9 to 3.0) at 24 months after surgery. No significant change in the General Health Questionnaire score was observed in the noncase group during the follow-up. No significant change was noted in any of the secondary outcomes.

Conclusions  Psychological distress was associated with mild primary hyperparathyroidism and was ameliorated after surgery. The improvement, however, was limited in extent and duration.

From the Departments of Endocrine Surgery (Drs Okamoto and Obara), Hygiene and Public Health II (Dr Okamoto), and Psychiatry (Dr Kamo), School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Outcome Study of Psychological Distress and Nonspecific Symptoms in Patients With Mild Primary Hyperparathyroidism—Invited Critique
Richard E. Burney
Arch Surg. 2002;137(7):784.
EXTRACT | FULL TEXT