Psikoloji Çalışmaları; 1971;9():19-82
Hipertiroidi'nin Psikolojik Hususiyetleri
E Cantez
İstanbul Üniversitesi, İstanbul
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Psychological Aspects of Hyperthroidism
The development of psychological tests that can be applied easily
and scored by objective criteria has been quite helpful in the assessment
of certain illnesses where psychological factors are said to play a role.
Quite recently, a series of short yet rather interesting studies have been
done throughout the world with the idea of observing psychological factors
In some «somatic» illnesses and with the hope of understanding their
nature.
Since the eighteenth century, it was known that emotional disturbances
accompany disorders of the thyroid gland; the emotional disorders can
mostly be considered as neurotic symptoms as a part of the clinical picture
of hyperthyroidism. Thyrotoxic patients are hyper sensitive, and thyroidal
function often influences their mental and emotional lives. Besides this,
anxiety and emotional stimuli are said to play a significant role in the developement
of thyrotoxicosis which frequently precedes the onset of the
condition. In the present study our problem was to investigate the behavioral
changes together with emotional disturbances in the areas of motor performances
such as precision, steadiness, motility, endurence, reaction times
both to auditory and visual stimuli, simple motor learning tasks, memory
etc. of our study groups. By using these simple yet reliable psychological
techniques, we hoped to predict to certain degrees the outcome of various
aspects of the illness and help the clinician in the future for diagnostic and
prognostic purposes.
With the thyrotoxic patients as the experimental group, three other
control groups were also included such as illnesses due to the disturbances
of the thyroid gland, other endocrinal diseases like the disturbances of
adrenal, pitutiary etc., glands metablic disturbances, various types of skin
diseases and a normal control group which was psychologically and physically
accepted as healthy.
In the present study 135 male and female thyrotoxic patients were
examined, the mean age being 36 with a range of 54 for females; and 40
as the mean age and 53 as the range of the male subjects. On the average
they were from middle socioeconomic group with a mixed educational level.
Each patient in the experimental group was matched with that of normal
controls for various aspects. The other controls were matched as a whole
with the experimental group.
The clinical diagnosis of all the subjects in the study was confirmed
by various medical laboratory tests. The psychological examination was
carried out for all patients before medical treatment. Those of the experimental
group, that were available, were also examined- after treatment in
order to observe their degree of behavioral responses to treatment.
A set of three groups of eleven different psychological tests were used
in the study. The first group consisted of various motor coordination and
ability tests, together with reaction time experiments. In the second group
there were the tests of simple motor learning (mirror tracing), and immediate
memory. In the third and last group two tests of personality and emotionality
were used.
The results of the tests obtained from the thyrotoxic patients were
compared first with those of normal controls, secondly with the results of
other control groups and thirdly their own results before and after treatment.
Most of the test performances of hyperthyroids were compared with
HIPERTIROIDI'NI N PSIKOLOJI K ÖZELLIKLER I 21
other groups by calculating the «t» values. The results of all the tests of
the experimental group with those of normal controls were found to be all
statistically significant, and there were also significant results obtained for
the other control groups.
As for the results of the Minnesota Multiphasic Personality Inventory
(MMPI), the experimental group showed a marked profile type with quite a
high elevation at the (Pa), (D) and (Sc) scales respectively. The profile of
the patients after treatment showed the same characteristic but with a
decrease toward the normal range.
In the Rorschach tests, the subjects were shown a series of ten ink
blots that were quite meaningless. Subjects were asked to describe what
they saw in them. The responses given were based upon the conscious
and subconscious experience of the patients. In the scoring process, it was
attempted to be as objective as possible. And statistical analysis were
applied to the responses rather than the traditional analytical study. All
the results were compared by calculating their «t» value. The results for
various factors showed highly significant differences for the experimental
and the normal control groups. The most striking difference between the
experimental and control groups was seen on the W/ M ratio, and the poor
output of responces for the experimental group. In the hyperthyroids W/ M
ratio was found to be quite high, whereas in the normal group, it was
within the range of expected ratio.
As a result of this study we can conclude that psychological assessment
of diseases through the use of well known psychological techniques emerge
as a very useful tool in the diagnosis and treatment of diseases, and that
psychological testing should take the due consideration it deserves along
with the other physiological examinations.