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Abstract
Self-rated psychiatric symptoms were investigated in 30 patients referred for surgery
because of primary hyperparathyroidism (HPT) (serum calcium, 2.87 ± 0.21 mmol/L) in
38 subjects detected in a health screening, with 15 years of mild hypercalcemia and
probable HPT (serum calcium, 2.66 ± 0.09 mmol/L), and in38 normocalcemic control subjects.
The psychiatric symptomatology was evaluated by use of the Hopkins Symptom Checklist
(HSCL-56), a self-rating symptom scale. The patients with verified HPT had the highest
mean HSCL score, 89.1 ± 20.1 before surgery, compared with 76.6 ± 17.0 (p < 0.01)
in the health survey hypercalcemic patients and 73.8 ± 16.0 (p < 0.001) in the controls.
The factors for anxiety, depression, and cognitive symptoms were the most pronounced
in the HPT patients and were also increased among the mildly hypercalcemic persons
of the health survey, compared with the controls. Somatic symptoms such as headache,
back pain, chest pain, and weakness were equally common in HPT and in the controls,
and measurements of isometric muscle strength of knee extension did not demonstrate
reduction of muscle strength in the health survey hypercalcemic patients. Follow-up
of the HPT patients 1year after parathyroid surgery revealed a marked improvement
in mental health (HSCL score 73.2 ± 13.7, p < 0.001). In the health survey hypercalcemic
patients, neither the psychiatric symptomatology nor the muscle strength were influenced
by 6 months of oral vitamin D therapy (alphacalcidol). The results demonstrate that
psychiatric symptoms are experienced frequently by patients with HPT and minimum to
moderate increases in the serum calcium level and that these disturbances are reversed
by parathyroid surgery.
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Article info
Publication history
Accepted:
May 20,
1988
Footnotes
☆Supported by a grant from Fredrik och Ingrid Thurings Foundation, Stockholm, Sweden, and the Swedish Medical Research Council.
Identification
Copyright
© 1989 Published by Elsevier Inc.
