Pessimistic ‘Type D’ Personalities Have A Tougher Time Managing Hypothyroidism

by Liz Neporent
April 10, 2024 at 10:25 AM UTC

Understanding the link between Type D personality and hypothyroidism can enhance patient care and treatment satisfaction.

Clinical Relevance: Psychological traits can influence physical health outcomes

  • More than half of hypothyroidism patients have a Type D personality.
  • Type D personality traits correlate with poorer symptom control, treatment satisfaction, and overall well-being in hypothyroidism patients.
  • Type D individuals with hypothyroidism also report higher rates of anxiety and depression.
  • Understanding the link between Type D personality and hypothyroidism can improve the patient experience and overall quality of life.

More than half of people diagnosed with hypothyroidism tend to have a gloomy outlook on life – and it has a significant impact on their health outcomes. 

In  a study just published in The Journal of Clinical Endocrinology & Metabolism, those with the so-called “Type D” personality who made up the majority of the more than 3500 subjects who live with a low functioning thyroid gland reported higher levels of anxiety, depression, poor control of symptoms, dissatisfaction with care, and an overall negative effect on everyday living.

Type D personality refers to highly anxious individuals who worry a lot but tend to keep their feelings to themselves, especially in social situations. The British researchers who conducted the study said that understanding the link between this personality type and hypothyroidism can help guide healthcare providers to find ways of improving patient care and treatment satisfaction.

“We think that there are two likely interpretations, which may not be mutually exclusive – type D personality and hypothyroidism share similar underlying causes, or people with type D personality may perceive treatment outcomes more negatively,” said study author Petros Perros, M.D., of Newcastle University in Newcastle upon Tyne, U.K.

Study Findings

The study employed a multinational, cross-sectional survey design to explore the prevalence of Type D personality among individuals with hypothyroidism and its association with patient-reported outcomes. 

Conducted online, the researchers asked nearly 4,000 individuals with self-reported, treated hypothyroidism from various countries to respond to a validated questionnaire assessing Type D personality traits. They also included questions about demographics, treatment satisfaction, symptom control, and how they managed their hypothyroidism on a daily basis. 

With a substantial response rate, the study successfully gathered data from 3,523 valid respondents, providing a clear window into the psychological profile of the typical hypothyroidism patient and how their psychology was related to both their outlook and outcomes. 

Results revealed that individuals with hypothyroidism who exhibit Type D personality traits are significantly more likely to experience a range of adverse consequences compared to those without these traits. 

Specifically, the study found that the 54.2 percent of respondents identified with Type D personality had:

  • Poorer control of symptoms related to hypothyroidism, despite medication
  • Higher levels of dissatisfaction with the care and treatment they received for their condition
  • A more pronounced negative effect of hypothyroidism on quality of life and the ability to carry out everyday tasks

Study Interpretation

While the study didn’t quantify the exact likelihood or provide specific percentages for each outcome, it did establish clear statistical associations. 

These associations, the researchers stated, underscore the influence of Type D personality on the patient experience and outcomes in hypothyroidism. Further, they suggest that individuals with this personality type are more prone to experiencing challenges in managing their condition, feeling satisfied with their treatment, and maintaining well-being.

This underlines the importance of considering psychological factors, such as personality type, in the treatment and care of hypothyroidism to improve patient outcomes. And, they added, it could explain why some people don’t respond to treatment or feel good about the medical care they receive.

Future Implications

Recognizing Type D personality traits in patients with hypothyroidism could encourage a more holistic approach to treatment, integrating psychological support alongside traditional thyroid management strategies. 

Such an approach would not only help balance thyroid hormone levels, it could also promote the overall well-being of patients, potentially reducing the burden of anxiety, depression, and dissatisfaction with their care experience. Tailoring care plans to include mental health considerations, could greatly enhance the daily experiences and  boost satisfaction for individuals with hypothyroidism.

Addressing Type D psychology could potentially benefit other chronic health conditions as well. Previous studies have shown that this anxiety-driven personality type also associates with worse outcomes in cardiovascular disease, diabetes, cancer, and several other diseases.

“Further research is needed to confirm our findings and determine if it is possible to predict how newly diagnosed patients with hypothyroidism will respond to treatment based on personality traits. If so, studies could be designed specifically for such patients, to determine if interventions can improve outcomes,” Perros said.

Further Reading:

Study Reveals Stronger Genetic Link to TRD

Therapist-Guided Versus Self-Guided Cognitive-Behavioral Therapy

Bullying Victims Vulnerable to Mental Health Problems Later


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