AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO026030035
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ORIGINAL RESEARCH ARTICLE

High prevalence and interrelated psychological distress among patients with early-stage papillary thyroid carcinoma

Wanru Qiu1 ,  Desheng Tang2 ,  Aoxue Zhang1,3 ,  Sen Li1,3 ,  Cong Zhou1,3,4,5*
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1 School of Mental Health, Jining Medical University, Jining, Shandong, China
2 Department of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
3 Jining Key Laboratory of AI-Assisted Diagnosis and Treatment of Mental Disorders, Jining, Shandong, China
4 Department of Psychology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
5 Center for Evidence-Based Medicine, Jining Medical University, Jining, Shandong, China
EJMO, 026030035 https://doi.org/10.36922/EJMO026030035
Received: 17 January 2026 | Revised: 4 March 2026 | Accepted: 9 April 2026 | Published online: 4 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Papillary thyroid carcinoma (PTC) has an excellent survival prognosis, yet a growing body of evidence suggests survivors bear a significant psychosocial burden. The multidimensional psychological profile and the interrelationships between specific distress factors in early-stage PTC patients remain inadequately characterized.

Objective: This study aimed to quantify psychological distress in early-stage PTC patients compared to healthy controls (HCs) and to explore the correlational network among anxiety, depression, fear of progression, stigma, shame, and self-esteem within the patient group.

Methods: In this cross-sectional study, 14 patients with early-stage PTC and 15 age- and sex-matched HCs were enrolled. Psychological assessment was performed using clinician-administered (Hamilton Anxiety Rating Scale [HAMA] and Hamilton Depression Rating Scale [HAMD]) and self-report scales (Self-Rating Anxiety Scale [SAS], Self-Rating Depression Scale [SDS], Pittsburgh Sleep Quality Index [PSQI], Beck Scale for Suicidal Ideation, Fear of Progression Questionnaire-Short Form [FoP-Q-SF], Social Impact Scale [SIS], Shame and Stigma Scale in Head and Neck Cancer Patients [SSS-HNC], Self-Esteem Scale [SES], and Perceived Social Support Scale). Group comparisons were made using t-tests, and Pearson correlations were analyzed within the PTC group.

Results: Compared to HCs, PTC patients reported significantly higher levels of anxiety (HAMA: 10.07 ± 6.03 vs. 0.67 ± 1.11, p < 0.001; SAS: 5.09 ± 1.36 vs. 1.03 ± 0.27, p < 0.001), depression (HAMD: 8.29 ± 4.70 vs. 1.33 ± 2.29, p < 0.001; SDS: 3.39 ± 0.91 vs. 0.53 ± 0.64, p < 0.001), and sleep disturbance (PSQI: 6.36 ± 4.72 vs. 3.47 ± 1.81, p < 0.001). Correlation analysis revealed strong associations between clinician-rated and self-reported anxiety (HAMA–SAS: r = 0.77) and between anxiety and depression (HAMA–HAMD: r = 0.83). Fear of progression was positively correlated with clinician-rated anxiety (FoP-Q-SF–HAMA: r = 0.53). Notably, both self-esteem (SES) and perceived social stigma (SIS) showed negative correlations with internalized shame (SSS-HNC) (r = −0.54 and r = −0.42, respectively).

Conclusion: Patients with early-stage PTC experience a significant and interconnected burden of psychological distress. The counterintuitive finding of lower perceived stigma correlating with higher internalized shame suggests a unique psychosocial dynamic in this population, likely influenced by the “good cancer” narrative. These preliminary findings highlight the potential value of integrated psychological assessment and tailored supportive care in PTC survivorship and require further validation in larger-scale studies.

Keywords
Papillary thyroid carcinoma
Psychological distress
Anxiety
Depression
Stigma
Funding
This study was supported by the Medical and Health Science and Technology Development Plan of Shandong Province (202304011343), the Graduate Education and Teaching Reform Research Project of Shandong Province (SDYJSJGC2024066), the Research Project of AI-Enabled Education and Teaching (JYJGZX2025017), and the Practical Teaching Education Research Program of Jining Medical University (JYSJ2024B14, JYSJ2024C23).
Conflict of interest
The authors declare that there is no conflict of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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