Effects of Anxiety on Thyroid Nodules Among Adolescents - A Cross-sectional Study from Jiangsu, China

Abstract Background With the rising detection rates of thyroid nodules (TNs), increasing attention is being given to their influencing factors, particularly psychological ones. Objectives To explore the association between anxiety and TNs in adolescents. Methods A cluster sampling method was used to select 11 counties in Jiangsu province, where a screening scale for Children's Anxiety Related disorders (SCARED) was conducted. The students' thyroids were examined using portable ultrasound with a high precision probe operating at a frequency of over 7.5 MHz and a resolution of 1 mm. TNs were defined as nodules with a diameter ≥ 5 mm. Random urine samples were collected from all students, and urinary iodine content was assessed using arsenic cerium catalytic spectrophotometry. Results A total of 1,167 senior high school students were surveyed, revealing a detection rate of thyroid nodules (TNs) of 5.7%. A positive correlation between anxiety disorders and TNs was found among all students (OR = 1.75, 95% CI; 1.06–2.89, P = 0.029), male students (OR = 1.94, 95% CI; 1.09–4.18, P = 0.033), and 12th-grade students (OR = 2.13, 95% CI; 1.08–5.11, P = 0.042). A positive correlation was observed between panic disorder (PN) and TNs was observed in all study subjects (OR = 2.18, 95% CI; 1.17–3.99, P = 0.012), female student (OR = 2.73, 95% CI; 1.20–6.15, P = 0.015), 11th-grade students (OR = 4.24, 95% CI; 1.42–12.47, P = 0.009). Additionally, a positive correlation was found between separation panic (SP) and TNs in 11th-grade students (OR = 1.17, 95% CI; 1.03–1.62, P = 0.015), and between social anxiety (SC) and TNs in male students (OR = 2.57, 95% CI; 1.08–6.49, P = 0.037), as well as in 11th-grade students (OR = 3.23, 95% CI; 1.04–10.92, P = 0.038). Conversely, a negative correlation was found between school avoidance (SH) and TNs in all students (OR = 0.37, 95% CI; 0.17–0.74, P = 0.008), male students (OR = 0.08, 95% CI; 0.01–0.34, P = 0.003), 11th-grade students (OR = 0.27, 95% CI; 0.05–0.89, P = 0.039), and 12th-grade students (OR = 0.22, 95% CI; 0.04–0.89, P = 0.032) Conclusions Anxiety disorders are associated with the presence of TNs. Specific anxiety subtypes, such as panic disorder and separation panic, demonstrate distinct correlations with the occurrence of TNs across different gender and grade levels.