The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial

Background: Childhood adversity and trauma have been linked to altered thyroid function and hypothyroidism, yet few randomised controlled trials (RCTs) have examined the effectiveness of trauma-focused psychological interventions in patients with Hashimoto’s thyroiditis (HT).Objective: This study ai...

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Main Authors: Maria-Magdalena Macarenco, Cristian Opariuc-Dan, Teodora Georgescu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:European Journal of Psychotraumatology
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Online Access:https://www.tandfonline.com/doi/10.1080/20008066.2025.2520636
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author Maria-Magdalena Macarenco
Cristian Opariuc-Dan
Teodora Georgescu
author_facet Maria-Magdalena Macarenco
Cristian Opariuc-Dan
Teodora Georgescu
author_sort Maria-Magdalena Macarenco
collection DOAJ
description Background: Childhood adversity and trauma have been linked to altered thyroid function and hypothyroidism, yet few randomised controlled trials (RCTs) have examined the effectiveness of trauma-focused psychological interventions in patients with Hashimoto’s thyroiditis (HT).Objective: This study aimed to evaluate the effectiveness of Identity-Oriented Psychotrauma Therapy (IOPT) in adults with HT, focusing on both immunological and psychological outcomes.Method: This parallel-group RCT randomised 70 adults with HT (93.94% women; age 25–57) to receive treatment as usual (TAU) or TAU plus IOPT. The intervention comprised 10 bimonthly group sessions, one session every two weeks. Outcomes included thyroid peroxidase (TPO-ab) and thyroglobulin (TG-ab) antibodies, along with depression, anxiety, stress, dissociation, alexithymia, and anger, assessed at baseline, post-treatment, and 3-month follow-up. A series of 2-way mixed-model ANOVAs and Bonferroni-corrected post-hoc tests were used. Missing data due to attrition – particularly in the control group (37%) – were addressed via multiple imputation, and sensitivity analyses were conducted to test robustness.Results: Initial analyses suggested that IOPT significantly reduced TPO-ab levels compared to TAU (p < .001), with effects maintained at follow-up (p = .01); however, these effects were not replicated in complete case analysis. IOPT led to significant improvements in dissociation (p = .03), alexithymia (p < .001), depression (p < .001), anxiety (p < .001), stress (p = .015), state anger (p = .009), anger-in (p = .009), and quality of life (p = .042) at follow-up.Conclusion: These preliminary findings suggest that IOPT, when added to standard medical care, may offer psychological benefits for HT patients and could potentially influence immunological outcomes. However, given the attrition-related sensitivity of some results, further replication in larger, well-retained samples is necessary before drawing definitive conclusions.Trial registration: ClinicalTrials.gov identifier: NCT04600349.
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spelling doaj-art-ce83621da01246cfb4bbcfa0810586e12025-08-20T03:27:05ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2520636The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trialMaria-Magdalena Macarenco0Cristian Opariuc-Dan1Teodora Georgescu2Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, RomaniaDepartment of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, RomaniaDepartment of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, RomaniaBackground: Childhood adversity and trauma have been linked to altered thyroid function and hypothyroidism, yet few randomised controlled trials (RCTs) have examined the effectiveness of trauma-focused psychological interventions in patients with Hashimoto’s thyroiditis (HT).Objective: This study aimed to evaluate the effectiveness of Identity-Oriented Psychotrauma Therapy (IOPT) in adults with HT, focusing on both immunological and psychological outcomes.Method: This parallel-group RCT randomised 70 adults with HT (93.94% women; age 25–57) to receive treatment as usual (TAU) or TAU plus IOPT. The intervention comprised 10 bimonthly group sessions, one session every two weeks. Outcomes included thyroid peroxidase (TPO-ab) and thyroglobulin (TG-ab) antibodies, along with depression, anxiety, stress, dissociation, alexithymia, and anger, assessed at baseline, post-treatment, and 3-month follow-up. A series of 2-way mixed-model ANOVAs and Bonferroni-corrected post-hoc tests were used. Missing data due to attrition – particularly in the control group (37%) – were addressed via multiple imputation, and sensitivity analyses were conducted to test robustness.Results: Initial analyses suggested that IOPT significantly reduced TPO-ab levels compared to TAU (p < .001), with effects maintained at follow-up (p = .01); however, these effects were not replicated in complete case analysis. IOPT led to significant improvements in dissociation (p = .03), alexithymia (p < .001), depression (p < .001), anxiety (p < .001), stress (p = .015), state anger (p = .009), anger-in (p = .009), and quality of life (p = .042) at follow-up.Conclusion: These preliminary findings suggest that IOPT, when added to standard medical care, may offer psychological benefits for HT patients and could potentially influence immunological outcomes. However, given the attrition-related sensitivity of some results, further replication in larger, well-retained samples is necessary before drawing definitive conclusions.Trial registration: ClinicalTrials.gov identifier: NCT04600349.https://www.tandfonline.com/doi/10.1080/20008066.2025.2520636Hashimotoautoimmune thyroiditisintention methodIOPTpsychotraumaPsicotrauma
spellingShingle Maria-Magdalena Macarenco
Cristian Opariuc-Dan
Teodora Georgescu
The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial
European Journal of Psychotraumatology
Hashimoto
autoimmune thyroiditis
intention method
IOPT
psychotrauma
Psicotrauma
title The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial
title_full The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial
title_fullStr The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial
title_full_unstemmed The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial
title_short The influence of identity-oriented psychotrauma therapy on Hashimoto disease activity: a randomised controlled trial
title_sort influence of identity oriented psychotrauma therapy on hashimoto disease activity a randomised controlled trial
topic Hashimoto
autoimmune thyroiditis
intention method
IOPT
psychotrauma
Psicotrauma
url https://www.tandfonline.com/doi/10.1080/20008066.2025.2520636
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