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Shokufeh Tavassoli, Richard W. Lee, Paul White, Jane Murray, Jimmy Uddin, Rathie Rajendram, Colin M. Dayan, Sue Jackson, CIRTED Investigators; The Negative Psychosocial Impact Of Thyroid Eye Disease - Comparing Results From A Preliminary Cohort Of CIRTED Trial Participants With Other Facially Disfiguring Conditions. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1009.
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Thyroid eye disease (TED) can be a visually disabling and cosmetically disfiguring condition. There is a paucity of research on the psychosocial impact of TED. Our goal was to compare psychosocial distress in a preliminary cohort of CIRTED trial participants (www.cirted.org) to patients with other facially disfiguring conditions.
77 participants were prospectively recruited (53 female, 24 male; age range: 25-73 years). All participants were given a questionnaire pack comprising scales measuring general anxiety and depression (HADS); quality of life (WHOQoL-Bref); and social anxiety and social avoidance as a result of appearance (DAS-24). The other facially disfiguring conditions comprised patients with pre-treatment facial burns (n=32), head and neck cancer (n=13) and other maxillofacial conditions (n=24).
Independent sample t-test analyses to compare calculated means and standard deviations for the CIRTED group with patients with other facially disfiguring conditions (as shown in table 1) revealed that CIRTED trial participants reported significantly greater levels of depression (p<.015) than all the other facially disfiguring conditions; significantly more general anxiety (HADS) than the facial burns and the other maxillofacial conditions groups (p<.002); and higher levels of social anxiety (DAS-24) than the facial burns and other maxillofacial conditions (p<.001). The CIRTED trial participants reported significantly reduced quality of life compared to the other maxillofacial conditions group (physical domain, p<.001; psychological domain, p<.001; environment domain, p<.005) and rated their psychological quality of life as being significantly poorer than that observed in the facial burns group (p<.001).
All of the conditions were associated with high levels of psychosocial distress and reduced psychosocial functioning. However, patients with TED were significantly more affected than patients with facial burns, head and neck cancer and other maxillofacial conditions.
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