Parathyroidectomy, Elevated Depression Scores, and Suicidal Ideation in Patients With Primary Hyperparathyroidism: Results of a Prospective Multicenter Study

OBJECTIVE To assess anxiety and depression symptoms, suicidal ideation, and health-related quality of life (HRQOL) in a large series of consecutive patients with primary hyperparathyroidism (pHPT) before and after parathyroidectomy. DESIGN This prospective multicenter study investigated preoperative and postoperative depression, anxiety, suicidal ideation, and HRQOL in patients with pHPT and compared these variables with a control group with nontoxic thyroid nodules. PATIENTS The study included 194 patients with pHPT and 186 control subjects. MAIN OUTCOME MEASURES Depression was evaluated with the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire–9, which also assessed suicidal ideation. Anxiety was evaluated with the HADS. Health-related quality of life was measured with the 36-Item Short Form survey. RESULTS Parathyroidectomy achieved a 98% cure rate. Preoperatively, severe depression (HADS score ≥11) was seen in 20% of the pHPT group and 9% of the control group. The Patient Health Questionnaire–9 detected moderate to severe depression in 17% of the patients with pHPT and 7% of the control subjects. Patients with pHPT had higher HADS anxiety scores (mean, 7.7) than control subjects (P