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Waleed K W Al-Badri Orbital center Amsterdam, Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands

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Hinke Marijke Jellema Orbital center Amsterdam, Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands

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Arnaud R G G Potvin Orbital center Amsterdam, Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands

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Ruth M A van Nispen Amsterdam University Medical Center, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, the Netherlands

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Peter H Bisschop Department of Endocrinology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands

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Peerooz Saeed Orbital center Amsterdam, Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands

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reliable assessment tool for patients, even to evaluate the effects of different treatments ( 7 , 8 , 9 ). Furthermore, many studies have reported the association of thyroid dysfunction and GD with psychiatric disorders, mainly depression and anxiety

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Hanneke J C M Wouters Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Bruce H R Wolffenbuttel Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Anneke C Muller Kobold Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands

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Thera P Links Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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Gerwin Huls Department of Hematology, University of Groningen, University Medical Center Groningen, The Netherlands

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Melanie M van der Klauw Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

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as depression and impaired mental well-being ( 3 ). Earlier, we demonstrated that HRQoL is impaired in women using levothyroxine compared with those not using levothyroxine ( 4 ). Several possible causes of reduced HRQoL in hypothyroidism have been

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Sophie-Charlotte Drogge Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Mirjam Frank Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Carolin Girschik Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Karl-Heinz Jöckel Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Dagmar Führer-Sakel Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Börge Schmidt Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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bone fractures ( 6 ). Even psychological symptoms such as depression ( 7 ) or reduced quality of life ( 8 ) are associated with subclinical thyroid dysfunction. Because thyroid-stimulating hormone (TSH) reacts strong to minor changes in thyroid hormone

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Yukari Maki Department of Pediatric Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Kiyomi Horiuchi Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Takahiro Okamoto Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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factors include childhood adversity, history of depression, trait anxiety, and loneliness. The perpetuating factors involve a cognitive process characterized by a lack of confidence with an expectation of negative outcomes, reductions in physical activity

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Elizabeth J de Koster Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Olga Husson Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
Division of Clinical Studies, Institute of Cancer Research, London, UK

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Eveline W C M van Dam Department of Internal Medicine, Division of Endocrinology, location VU University Medical Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands

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G Sophie Mijnhout Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands

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Romana T Netea-Maier Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Centre, Nijmegen, The Netherlands

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Wim J G Oyen Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
Department of Biomedical Sciences and Humanitas Clinical and Research Centre, Department of Nuclear Medicine, Humanitas University, Milan, Italy

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Marieke Snel Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands

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Lioe-Fee de Geus-Oei Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands

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Dennis Vriens Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands

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for the EfFECTS trial study group
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, suggesting that a benign molecular test result provided similar reassurance of a low risk of malignancy ( 24 ). Patients who underwent diagnostic surgery for a suspicious molecular test result showed deteriorated goitre, depression, and anxiety scores at the

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