| Objective:Objective:Thyroid nodules are a chronic disease with a high global prevalence,and emotions are an important risk factor affecting the occurrence and development of the disease.Research has shown that life events are the initiating factors leading to emotional changes,and individual physiological and psychological characteristics are the key factors affecting emotions.But what specific events in daily life can cause emotional changes?What are the differences in the performance of different personalities and physiological characteristics when facing life events?The aim of this study is to select thyroid nodules patients who are closely related to emotions as the research subjects,to further explore the correlation between emotional stimulation of thyroid nodules patients and life events,and to lock in the relationship between individual psychological and physiological characteristics of patients and emotions.The scientific hypothesis that"life events are the initiating factor of emotional stimulation of thyroid nodule patients and there are differences in psychological and physiological characteristics among different individuals"is proposed.Furthermore,it provides new ideas and methods for personalized prevention and treatment of thyroid nodules in traditional Chinese and Western medicine.Methods:Clarify the relationship between emotions,life events,thyroid nodules,and the relationship between individual psychology,physiology,and emotions through literature review.Using a population-based epidemiological survey method,patients with thyroid nodules were selected as the subjects,while those with no abnormal physical examination were selected as the healthy control group.Eight questionnaires were completed at one time:the General Situation Questionnaire,State Trait Anger Expression Scale STAXI-2,Negative Life Events Scale(LES),Self Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS),Eysenck Personality Questionnaire(EPQ Adult),Pittsburgh Sleep Quality Index Questionnaire(PSQI),and the Fatigue Scale FS-14.The quantitative questionnaires were then recovered and double-entered into Excel to create a database.Use SPSS27.0 software to apply binomial logistic regression for statistical analysis of the correlation between depression,anxiety,anger,and life events in patients with thyroid nodules.Use the backward Wald method to gradually regression screen for significant risk factors.An OR value greater than 1 is a risk factor for triggering depression,anxiety,and anger,while an OR value less than 1 is a protective factor for triggering depression,anxiety,and anger.On this basis,a binomial logistic regression was applied to analyze the correlation between depression,anxiety,anger,personality,sleep,and fatigue in patients with thyroid nodules.When comparing the case group with the control group,a chi-square test was used,with a P<0.05 as the statistically significant difference.Results:A total of 153 patients with thyroid nodules were included in the survey,including 15 males and 138 females,with a male to female ratio of 1:10.86;The minimum age is 24 years old and the maximum age is 73 years old.The age range of the subjects is mainly 30 to 40 years old(27.3%),41 to 50 years old(32.7%)and 51 to 60 years old(23.3%).Statistical analysis showed that 46 patients with thyroid nodules were in a depressive state,accounting for 30.1%of the total number;34 people were in anxiety state,accounting for 22.2%;There were 15 people with anxiety and depression,accounting for9.8%;27 people were angry,accounting for 17.6%.Life events occur most frequently at the age of 30-40,with an average of 2.77;The top ten frequencies of incidents are:"children with learning difficulties","marital emotional breakdown","medium loan","family seriously ill","miscarriage","serious dispute between husband and wife","misbehavior of children","property loss","death of parents","serious disease trauma","family disharmony","conflict with superiors","extramarital sexual relationship","massive loan","colleague dispute","employment frustration"."Parent death"(OR=25.865,95%CI=3.698～180.901)"family serious illness"(OR=51.451,95%CI=8.629～306.782)"children with learning difficulties"(OR=18.238,95%CI=21.772～642.133)"medium loan"(OR=102.758,95%CI=10.715～985.472)events were risk factors for depression in patients with thyroid nodules,and were positively related to the occurrence of depression in patients with thyroid nodules;"Couple emotional breakdown"(OR=55.779,95%CI=9.965～31.230),"family serious illness"(OR=109.467,95%CI=11.754～1019.484),"serious disease trauma"(OR=10.071,95%CI=1.170～86.696),"abortion"(OR=12.365,95%CI=1.454～105.167)and the occurrence of anxiety in patients with thyroid nodules were positively correlated;The event of"spouse death"(OR=0.004,95%CI=0.000-0.127)was negatively correlated with the occurrence of anxiety in patients with thyroid nodules;The events of"marital emotional breakdown"(OR=22.849,95%CI=1.953～267.270),"family serious illness"(OR=533.469,95%CI=31.153～9135.246),"administrative disciplinary action"(OR=72.330,95%CI=1.088～4810.035),"children learning difficulties"(OR=51.570,95%CI=3.529～753.580)were positively correlated with the occurrence of depression and anxiety in patients with thyroid nodules;"Misconduct of children"(OR=19.747,95%CI=4.099～95.131)"sexual relationship outside marriage"(OR=30.447,95%CI=2.783～33.064)"serious dispute between husband and wife"(OR=11.087,95%CI=2.03～61.362)"abortion"(OR=9.033,95%CI=2.059～39.623)events were risk factors for anger in patients with thyroid nodules.In this study,there were 55 patients(35.9%)with extraverted bilious personality traits,38 patients(24.8%)with extraverted hemophilic personality traits,36 patients(23.5%)with introverted depressive personality traits,and 24 patients(15.7%)with introverted mucinous personality traits.The TI-RADS classification of thyroid nodules in extroverted patients is generally higher than that in introverted patients.In addition,the research on the correlation between individual different psychology,physiology,depression,anxiety and anger found that the main psychological characteristics of depression were"neuroticism N"and"masked L"(P<0.05);The main psychological characteristics of depression and anxiety were"neuroticism N"(P<0.05);The main physiological state of anger was"sleep disorder"(P<0.05).The rank sum test showed that anxiety,depression,and anger emotions in patients with thyroid nodules were independent influences on thyroid TI-RADS grading(p<0.05).In addition,a total of 75 people were included in the control group.The case group and control group showed depression(X~2=17.981,P=0.000);Anxiety(X~2=7.073,P=0.008);Depression and anxiety sleep(X~2=7.871,P=0.005);Anger(X~2=5.029,P=0.025);Sleep(X~2=38.494,P=0.000);Fatigue(X~2=43.275,P=0.000);There were differences(P<0.05)in negative life events(=30.098,P=0.000).Conclusion:(1)This study found that the prevalence of thyroid nodules in women is generally higher than that in men.and the prevalence of thyroid nodules is mainly concentrated in the age of 41-50 years old.Most patients are accompanied by depression,anxiety and anger.Most patients had depression,anxiety,anger and a high frequency of negative life events.(2)The results of this study preliminarily identified the specific life events that lead to emotional stimulation of thyroid nodules,and further verified which life events can cause depression,anxiety and anger in patients with thyroid nodules.By studying the correlation between depression,anxiety,and anger and negative life events in patients with thyroid nodules,we initially understood that the events that trigger negative emotions in patients with thyroid nodules are mainly family marriage,work and study,and economic status.(3)The patients with extraverted bilious personality traits account for the majority,and the disease severity of extraverted patients is generally higher than that of introverted patients.Individual psychological characteristics are important influencing factors in the development of depression and anxiety in patients with affective stimulation of thyroid nodules.(4)The different personality,sleep and fatigue of individuals are the important influencing factors of emotional stimulation to produce thyroid nodules.The individual’s physiological state is an important influence on the emotional stimulation of anger in patients with thyroid nodules.(5)Anxiety,depression,and anger emotions are independent factors affecting the TI-RADS grading of thyroid nodules.To provide targeted theoretical guidance for the prevention and treatment of thyroid nodules stimulated by emotions,with a view to enriching the theory of the liver,which is the master of draining and regulating emotions in Chinese medicine,and adding new theoretical guidance for the development of the theory of emotions and illnesses in Chinese medicine. |
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