Peng Wang,1,* Jing Yan,2,* Honghai He,1 Ying Che1 

1Medical Examination Center, Peking University Third Hospital, Beijing, People’s Republic of China; 2Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ying Che, Medical Examination Center, Peking University Third Hospital, North Garden Road & 49, Beijing, People’s Republic of China, Email cheyinghappy@126.com

Purpose: This study aims to investigate the mental health status of patients with high-risk and low-risk thyroid nodules (TNs), and the potential psychological risk factors that may exist in patients with high-risk nodules.
Patients and Methods: In this cross-sectional study, a total of 7645 adults who participated in physical examinations from January 2021 to December 2023 were included. During the physical examination, they all completed thyroid ultrasound examinations and laboratory tests, and filled out self-administered questionnaires, as well as the Symptom Checklist-90 (SCL-90) and the Stress Self-Assessment Questionnaire-53 (SSQ-53). These were used to collect general information, mental health status, and stress levels of the subjects. According to the degree of malignant risk, TNs were categorized into high-risk groups (HRG) and low-risk groups (LRG). Differences between the two groups were compared in terms of general information, mental health status scores, and laboratory indicators.
Results: The overall detection rate of TNs was 34.5%, with a significantly higher rate in women. There were significant differences in age and gender between HRG and LRG; The total score of SCL-90 in the HRG was significantly higher than that in LRG (128.78± 45.65 vs 120.59± 31.68, p=0.044); HRG exhibited a higher proportion of positive rates in the somatization (P=0.033) and anxiety (P=0.048) factors of the SCL-90. Among the 10 factors of SCL-90, the scores of somatization (P=0.011), obsessive-compulsive (P=0.010), interpersonal sensitivity (P=0.032), depression (P=0.036) and additional factors (diet and sleep) (P=0.008) in HRG were significantly higher. The results of SSQ-53 suggest that the overall stress level in HRG is higher, and the cognitive stress is significantly higher than that in LRG (P=0.003). Multivariate logistic regression analysis showed that age, gender, and SCL-90 total score were risk factors for high-risk TNs.
Conclusion: High-risk TNs are more common in females and older adults. The existence of high-risk TNs is related to poor mental health status.

Keywords: thyroid nodules, thyroid cancer, mental health, psychological stress, influencing factor