ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychology for Clinical Settings
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1567391
This article is part of the Research TopicAdolescent Emotional Disorders and Suicide Self-Harm Crisis InterventionView all 17 articles
Exploring the Psychological Landscape of Thyroid Nodules: Resilience, Anxiety, and Ultrasound Correlations
Provisionally accepted
- 1School of clinical medicine,Dali University,Yunnan,China, Yunnan,China, China
- 2Department of ultrasound medicine, First Affiliated Hospital of Dali University, Yunnan, China, Dali, China
- 3School of basic medicine, Dali University,Yunnan,China, Dali, China
- 4Department of Neurology, First Affiliated Hospital of Dali University,Yunnan,China, Dali, China
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Background: While thyroid nodules (TN) represent a prevalent clinical entity with ultrasoundguided management paradigms, the psychological sequelae of diagnostic imaging remain underexplored. This study investigates the complex interplay between ultrasound characteristics (C-TIRADS), psychological resilience, and anxiety manifestations in TN patients, addressing a critical gap in psychosomatic thyroidology. Methods: In this prospective cross-sectional study, 303 consecutive TN patients (mean age 47.3±12.1 years, 72.6% female) underwent standardized ultrasound evaluation using Aplio500 systems (Toshiba) at the First Affiliated Hospital of Dali University (October 2022-October 2024). C-TIRADS classifications were independently adjudicated by two radiologists. Psychological assessments employed the Hamilton Anxiety Rating Scale (HAMA) and Connor-Davidson Resilience Scale (CD-RISC) within 48 hours post-examination. Advanced statistical analyses included: (1) Multivariate regression modeling accounting for demographic confounders. (2) Spearman/Kendall correlation matrices. (3) Ordinal logistic regression for malignancy risk stratification.Results: Psychological assessments revealed that TN + patients exhibited elevated resilience (CD-RISC total: 64.04±14.166 vs 60.61±15.074; p = 0.025) but paradoxically higher anxiety levels (HAMA total: 32.51±8.516 vs 30.67±8.667; p = 0.005), demonstrating a negative correlation between resilience and anxiety severity (r = -0.259, p < 0.001). Ultrasonographic analysis demonstrated significant psychosomatic associations: Higher C-TIRADS classifications predicted reduced psychological resilience (OR = 0.327, 95%CI = 0.114-0.943, p = 0.044) and increased nodule multiplicity (OR = 0.135, 95%CI = 0.034-0.537, p = 0.005). Specific ultrasound features showed differential anxiety impacts -irregular margins increased anxiety risk (OR = 362.080, p = 0.037) while capsular protrusion showed protective effects (OR = 0.003, p=0.028). Symptom correlation analyses revealed: (1) Somatic anxiety showed stronger cardiovascular/respiratory system associations (r = 0.703-0.704). (2) Psychic anxiety correlated with cognitive-emotional domains (tension: r = 0.795; insomnia: r = 0.740). (3) Anxiety dimensions demonstrated differential resilience impacts -somatic anxiety primarily affected optimism (r = -0.146, p = 0.011), while psychic anxiety impaired overall resilience (r = -0.248, p < 0.001).Higher C-TIRADS malignancy risk classifications were associated with reduced resilience and increased anxiety , particularly in patients with irregular nodule edges. Clinical 2 approaches should focus on psychological support to boost resilience, treatment outcomes, and quality of life.
Keywords: 3782, Figure: 12, Table: 4) Thyroid nodules, Ultrasonic characteristics of C-TIRADS, Resilience, Anxiety, Correlations, thyroid nodules, Chinese Thyroid Imaging Reporting and Data System, Ultrasonic characteristic
Received: 01 Feb 2025; Accepted: 12 May 2025.
Copyright: © 2025 Zhang, Wang, Chen, Zhang, Chen, Cheng and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jing Wang, Department of ultrasound medicine, First Affiliated Hospital of Dali University, Yunnan, China, Dali, China
Lixia Wang, Department of Neurology, First Affiliated Hospital of Dali University,Yunnan,China, Dali, China
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