Background Adolescence is a critical developmental period characterized by significant psychological stress and a vulnerable neuroendocrine system. The potential link between anxiety and thyroid nodules (TNs) during this age range deserves attention. Objectives To explore the association between anxiety and TNs in adolescents. Methods A cluster sampling method was used to select 11 counties in Jiangsu province, where a screening scale for Children’s Anxiety Related disorders (SCARED) was conducted. The students’ thyroids were examined using portable ultrasound with a high precision probe operating at a frequency of over 7.5 MHz and a resolution of 1 mm. TNs were defined as nodules with a diameter ≥ 5 mm. Random urine samples were collected from all students, and urinary iodine content was assessed using arsenic cerium catalytic spectrophotometry. Results A total of 1,167 senior high school students were surveyed, revealing a detection rate of TNs of 5.7%. A positive correlation between anxiety disorders and TNs was found among all students (OR = 1.75, 95% CI; 1.06–2.89, P = 0.029), male students (OR = 1.94, 95% CI; 1.09–4.18, P = 0.033), and 12th-grade students (OR = 2.13, 95% CI; 1.08–5.11, P = 0.042). A positive correlation was observed between panic disorder (PN) and TNs was observed in all study subjects (OR = 2.18, 95% CI; 1.17–3.99, P = 0.012), female student (OR = 2.73, 95% CI; 1.20–6.15, P = 0.015), 11th-grade students (OR = 4.24, 95% CI; 1.42–12.47, P = 0.009). Additionally, a positive correlation was found between separation panic (SP) and TNs in 11th-grade students (OR = 1.17, 95% CI; 1.03–1.62, P = 0.015), and between social anxiety (SC) and TNs in male students (OR = 2.57, 95% CI; 1.08–6.49, P = 0.037), as well as in 11th-grade students (OR = 3.23, 95% CI; 1.04–10.92, P = 0.038). Conversely, a negative correlation was found between school avoidance (SH) and TNs in all students (OR = 0.37, 95% CI; 0.17–0.74, P = 0.008), male students (OR = 0.08, 95% CI; 0.01–0.34, P = 0.003), 11th-grade students (OR = 0.27, 95% CI; 0.05–0.89, P = 0.039), and 12th-grade students (OR = 0.22, 95% CI; 0.04–0.89, P = 0.032). Conclusions Anxiety disorders may be associated with the presence of TNs. Specific anxiety subtypes, such as panic disorder and separation panic, demonstrate distinct correlations with the occurrence of TNs across different gender and grade levels.

Effects of anxiety on thyroid nodules among Adolescents - A Cross-sectional study from Jiangsu, China

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发表日期：

2026年2月2日

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Yuting Xia,
Yunjie Ye,
Li Shang,
Mao Liu,
Yang Wang,
Peihua Wang

摘要

Background

Adolescence is a critical developmental period characterized by significant psychological stress and a vulnerable neuroendocrine system. The potential link between anxiety and thyroid nodules (TNs) during this age range deserves attention.

Objectives

To explore the association between anxiety and TNs in adolescents.

Methods

A cluster sampling method was used to select 11 counties in Jiangsu province, where a screening scale for Children’s Anxiety Related disorders (SCARED) was conducted. The students’ thyroids were examined using portable ultrasound with a high precision probe operating at a frequency of over 7.5 MHz and a resolution of 1 mm. TNs were defined as nodules with a diameter ≥ 5 mm. Random urine samples were collected from all students, and urinary iodine content was assessed using arsenic cerium catalytic spectrophotometry.

Results

A total of 1,167 senior high school students were surveyed, revealing a detection rate of TNs of 5.7%. A positive correlation between anxiety disorders and TNs was found among all students (OR = 1.75, 95% CI; 1.06–2.89, P = 0.029), male students (OR = 1.94, 95% CI; 1.09–4.18, P = 0.033), and 12th-grade students (OR = 2.13, 95% CI; 1.08–5.11, P = 0.042). A positive correlation was observed between panic disorder (PN) and TNs was observed in all study subjects (OR = 2.18, 95% CI; 1.17–3.99, P = 0.012), female student (OR = 2.73, 95% CI; 1.20–6.15, P = 0.015), 11th-grade students (OR = 4.24, 95% CI; 1.42–12.47, P = 0.009). Additionally, a positive correlation was found between separation panic (SP) and TNs in 11th-grade students (OR = 1.17, 95% CI; 1.03–1.62, P = 0.015), and between social anxiety (SC) and TNs in male students (OR = 2.57, 95% CI; 1.08–6.49, P = 0.037), as well as in 11th-grade students (OR = 3.23, 95% CI; 1.04–10.92, P = 0.038). Conversely, a negative correlation was found between school avoidance (SH) and TNs in all students (OR = 0.37, 95% CI; 0.17–0.74, P = 0.008), male students (OR = 0.08, 95% CI; 0.01–0.34, P = 0.003), 11th-grade students (OR = 0.27, 95% CI; 0.05–0.89, P = 0.039), and 12th-grade students (OR = 0.22, 95% CI; 0.04–0.89, P = 0.032).

Conclusions

Anxiety disorders may be associated with the presence of TNs. Specific anxiety subtypes, such as panic disorder and separation panic, demonstrate distinct correlations with the occurrence of TNs across different gender and grade levels.