Abstract
BACKGROUND: Post-thyroidectomy patients frequently experience depressive symptoms triggered by surgical trauma, fluctuating thyroid hormone levels, and the psychological burden of long-term surveillance; however, large-scale multivariable-adjusted risk-factor data remain scarce. AIM: To determine the prevalence and predictors of postoperative depression, and propose tailored mitigation strategies. METHODS: We enrolled 108 consecutive patients who underwent thyroidectomies at The First Affiliated Hospital of Hebei North University between January 2023 and January 2025. Depression was assessed using the Self-Rating Depression Scale (SDS), while coping styles and social support were evaluated using the Medical Coping Modes Questionnaire and Perceived Social Support Scale. Logistic regression was used to identify independent risk and protective factors. RESULTS: The mean SDS score was 52.58 ± 10.20; 62 patients (57.4%) met the criteria for depression (mild 32.4%, moderate 15.7%, severe 9.3%). Univariate analyses revealed higher depression rates among patients aged ≥ 60 years, those with ≤ high-school education, monthly family income < 3000 yuan, (131)I therapy, and avoidance/surrender coping; and lower social support (P < 0.05). Multivariate regression showed income < 3000 yuan (OR = 5.26, 95%CI: 1.89-14.60), (131)I therapy (OR = 5.70, 95%CI: 1.91-17.01), and avoidance/surrender coping (OR = 4.77, 95%CI: 1.51-15.11) as independent risk factors, whereas higher social support was protective (OR = 0.22, 95%CI: 0.09-0.54). CONCLUSION: Depression is common after thyroidectomy, and is driven by socioeconomic, treatment-related, and psychosocial factors. Targeted interventions that address coping skills and bolster social support should be integrated into postoperative care.