Temperament Traits as Key Modulators of Depression and Anxiety in Hyperthyroidism: Implications for Personalized Treatment

Introduction The relationship between thyroid hormone dysfunction and psychiatric symptoms is complex, with hyperthyroidism frequently presenting alongside mood and anxiety disorders. Temperament traits, enduring psychological characteristics, may significantly influence the clinical manifestation of depression and anxiety in hyperthyroid patients, yet they remain understudied. This study aimed to determine whether specific temperament traits in hyperthyroid individuals correlate with anxiety and depressive symptoms and explore their implications for personalized clinical management. Methods A total of 59 patients diagnosed with hyperthyroidism and 40 healthy controls participated in this study. All participants underwent clinical assessment, thyroid function testing (thyroid-stimulating hormone (TSH), T3, T4), and completed the Hospital Anxiety and Depression Scale (HADS) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Demographic and clinical parameters, including age, gender, body mass index (BMI), blood pressure, smoking status, and family history, were also documented. Statistical analyses included Mann-Whitney U tests for group comparisons, Spearman's correlation analysis for relationships between temperament traits and psychiatric symptoms, and generalized linear models (GLM) to identify predictors of depressive symptoms. Results Hyperthyroid patients exhibited significantly higher anxiety scores compared to controls (p<0.001), whereas depressive symptoms, although elevated, did not reach statistical significance (p>0.05). Temperament assessment revealed significantly increased depressive, cyclothymic, irritable, and anxious traits in patients compared to controls (p<0.001). Hyperthymic temperament showed no significant difference between groups. A notable positive correlation emerged between irritable temperament and increased depressive symptoms (r=0.635, p<0.001). Depressive temperament significantly predicted higher depression scores, while hyperthymic temperament appeared protective, associated with reduced depressive symptoms (p<0.05). Conclusions These findings highlight the importance of temperament traits as critical modulators of psychiatric outcomes in hyperthyroidism. Irritable and depressive temperaments may increase vulnerability to depressive disorders, whereas hyperthymic temperament could offer resilience. Integrating temperament assessment into clinical practice may enhance diagnostic precision and inform personalized therapeutic approaches, improving patient outcomes and quality of life.