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2026, Vol: 10, Issue: 9
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Review Article
Online Published: 09 Oct 2026
 


Association between anxiety disorders and hyperthyroidism: a systematic review

Khalil Ibrahim Bograin, Bshayer Shaker Alzawad, Zainab Abdullah Alhassan, ‏‏shorouq Hassan Al Rebh, ‏ramlah Sameer Alkhars, Noufa Saleh Alsubaie Saleh Alsubaie, Noor Ibraheem Bukhamsin, Maryam Hussain Alayesh, Fatin Abdulhmeed Aljaafar, Bayan Abdulrahman Alsultan, Ohood Ahmed Albahrani, Zahra Zaki Aljasass.


Abstract
Hyperthyroidism affects approximately 1.2% of the population and is frequently associated with anxiety disorders, yet the literature remains heterogeneous regarding the strength and nature of this association. This systematic review aimed to comprehensively examine the association between anxiety disorders and hyperthyroidism, assessing prevalence, bidirectional relationships, treatment outcomes, and quality-of-life implications. A systematic search of PubMed/MEDLINE, Embase, PsycINFO, Cochrane Library, Scopus, and Web of Science was conducted for studies published between 2021 and 2026. Included studies involved adults with biochemically confirmed hyperthyroidism and validated anxiety assessment. Two independent reviewers performed screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale and JBI checklists. Narrative synthesis was employed due to heterogeneity. Eleven studies (350,000+ participants) were included. Anxiety prevalence in hyperthyroid patients ranged from 30% to 60%, significantly exceeding that in euthyroid controls. The association was bidirectional: anxiety was both a consequence and a risk factor for hyperthyroidism, with hazard ratios increasing from 1.19 (mild anxiety) to 1.84 (severe anxiety). Notably, anxiety symptoms persisted in a substantial proportion of patients even after achieving biochemical euthyroidism. Quality of life was significantly impaired, with anxiety as an independent predictor of reduced well-being. Neurobiological mechanisms included hypothalamic-pituitary-thyroid axis dysregulation, sympathetic hyperactivity, and immune-mediated pathways. A significant bidirectional association exists between anxiety and hyperthyroidism, with persistent psychiatric comorbidity despite endocrine treatment. Routine psychiatric screening and integrated mental health care are essential in hyperthyroidism management.

Key words: Hyperthyroidism, anxiety disorders, Graves' disease, thyroid hormones, systematic review, comorbidity, mental health


 
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How to Cite this Article
Pubmed Style

Bograin KI, Alzawad BS, Alhassan ZA, Rebh HA, Alkhars S, Alsubaie NSAS, Bukhamsin NI, Alayesh MH, Aljaafar FA, Alsultan BA, Albahrani OA, Aljasass ZZ. Association between anxiety disorders and hyperthyroidism: a systematic review. IJMDC. Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480

Web Style

Bograin KI, Alzawad BS, Alhassan ZA, Rebh HA, Alkhars S, Alsubaie NSAS, Bukhamsin NI, Alayesh MH, Aljaafar FA, Alsultan BA, Albahrani OA, Aljasass ZZ. Association between anxiety disorders and hyperthyroidism: a systematic review. https://www.ijmdc.com/?mno=332591 [Access: October 09, 2026]. doi:10.24911/IJMDC.51-1787684480

AMA (American Medical Association) Style

Bograin KI, Alzawad BS, Alhassan ZA, Rebh HA, Alkhars S, Alsubaie NSAS, Bukhamsin NI, Alayesh MH, Aljaafar FA, Alsultan BA, Albahrani OA, Aljasass ZZ. Association between anxiety disorders and hyperthyroidism: a systematic review. IJMDC. Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480


Vancouver/ICMJE Style

Bograin KI, Alzawad BS, Alhassan ZA, Rebh HA, Alkhars S, Alsubaie NSAS, Bukhamsin NI, Alayesh MH, Aljaafar FA, Alsultan BA, Albahrani OA, Aljasass ZZ. Association between anxiety disorders and hyperthyroidism: a systematic review. IJMDC, [cited October 09, 2026]; Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480


Harvard Style

Bograin, K. I., Alzawad, . B. S., Alhassan, . Z. A., Rebh, . . H. A., Alkhars, . . S., Alsubaie, . N. S. A. S., Bukhamsin, . N. I., Alayesh, . M. H., Aljaafar, . F. A., Alsultan, . B. A., Albahrani, . O. A. & Aljasass, . Z. Z. (2026) Association between anxiety disorders and hyperthyroidism: a systematic review. IJMDC, Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480


Turabian Style

Bograin, Khalil Ibrahim, Bshayer Shaker Alzawad, Zainab Abdullah Alhassan, ‏‏shorouq Hassan Al Rebh, ‏ramlah Sameer Alkhars, Noufa Saleh Alsubaie Saleh Alsubaie, Noor Ibraheem Bukhamsin, Maryam Hussain Alayesh, Fatin Abdulhmeed Aljaafar, Bayan Abdulrahman Alsultan, Ohood Ahmed Albahrani, and Zahra Zaki Aljasass. 2026. Association between anxiety disorders and hyperthyroidism: a systematic review. International Journal of Medicine in Developing Countries, Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480


Chicago Style

Bograin, Khalil Ibrahim, Bshayer Shaker Alzawad, Zainab Abdullah Alhassan, ‏‏shorouq Hassan Al Rebh, ‏ramlah Sameer Alkhars, Noufa Saleh Alsubaie Saleh Alsubaie, Noor Ibraheem Bukhamsin, Maryam Hussain Alayesh, Fatin Abdulhmeed Aljaafar, Bayan Abdulrahman Alsultan, Ohood Ahmed Albahrani, and Zahra Zaki Aljasass. "Association between anxiety disorders and hyperthyroidism: a systematic review." International Journal of Medicine in Developing Countries Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480


MLA (The Modern Language Association) Style

Bograin, Khalil Ibrahim, Bshayer Shaker Alzawad, Zainab Abdullah Alhassan, ‏‏shorouq Hassan Al Rebh, ‏ramlah Sameer Alkhars, Noufa Saleh Alsubaie Saleh Alsubaie, Noor Ibraheem Bukhamsin, Maryam Hussain Alayesh, Fatin Abdulhmeed Aljaafar, Bayan Abdulrahman Alsultan, Ohood Ahmed Albahrani, and Zahra Zaki Aljasass. "Association between anxiety disorders and hyperthyroidism: a systematic review." International Journal of Medicine in Developing Countries Online First: 09 Oct, 2026. Web. 09 Oct 2026 doi:10.24911/IJMDC.51-1787684480


APA (American Psychological Association) Style

Bograin, K. I., Alzawad, . B. S., Alhassan, . Z. A., Rebh, . . H. A., Alkhars, . . S., Alsubaie, . N. S. A. S., Bukhamsin, . N. I., Alayesh, . M. H., Aljaafar, . F. A., Alsultan, . B. A., Albahrani, . O. A. & Aljasass, . Z. Z. (2026) Association between anxiety disorders and hyperthyroidism: a systematic review. International Journal of Medicine in Developing Countries, Online First: 09 Oct, 2026. doi:10.24911/IJMDC.51-1787684480




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