When Hormones Meet Habitual Mood: Temperament Clues to Anxiety and Depression in Primary Hyperparathyroidism

When a “medical” diagnosis comes with an emotional price tag

Primary hyperparathyroidism (often shortened to PHPT) is usually described in medical terms: overactive parathyroid glands, higher calcium levels, fatigue, bone and kidney risks. But many patients describe something else that’s harder to measure—feeling persistently on edge, unusually down, or emotionally “off” in ways that don’t fully match what’s happening in their lives. That mismatch matters, because anxiety and depression can shape sleep, relationships, work performance, and even how confidently someone follows a treatment plan.

The psychology question behind the research paper titled “The role of affective temperaments in predicting depression and anxiety symptoms in patients with primary hyperparathyroidism” is both practical and humane: are some people more emotionally vulnerable in PHPT because of their underlying affective temperament—their long-standing style of emotional reactivity—rather than the severity of their lab results? Temperament isn’t a passing mood. It’s the “default settings” that influence whether we worry easily, swing between highs and lows, or stay unusually upbeat. If temperament helps predict who struggles most, clinicians could spot risk earlier, take distress seriously, and tailor support instead of assuming symptoms will automatically resolve once calcium is corrected.

This summary explains what the study found, why it matters psychologically, and how it can be used in real clinical and everyday settings.

What stood out: a clear emotional pattern in PHPT patients

The study compared 47 patients with PHPT to 36 healthy controls. Participants completed a temperament questionnaire (the Memphis, Pisa, Paris and San Diego scale) and a symptom measure for anxiety and depression (the Hospital Anxiety and Depression Scale). Several findings were hard to ignore.

First, people with PHPT scored higher on depressive, cyclothymic (more mood variability), and anxious temperaments than the control group. They also reported higher levels of depression and anxiety symptoms overall. In plain terms: the PHPT group wasn’t just feeling worse; they also showed more enduring emotional styles linked to feeling worse.

Second, within the PHPT group, higher scores on depressive, cyclothymic, irritable, and anxious temperaments tended to go along with higher anxiety and depression symptoms. This looks like real life: someone with an anxious temperament may replay conversations after a work meeting, expect bad news from a doctor’s call, or feel a constant hum of worry at home. Someone with a cyclothymic temperament may have weeks of motivation and sociability followed by days of irritability, tearfulness, or withdrawal—patterns that can strain partnerships and make coworkers feel like they’re “walking on eggshells.”

Third, when the researchers examined predictors, anxious and cyclothymic temperaments predicted anxiety symptoms. Meanwhile, hyperthymic temperament (a tendency toward high energy and optimism) was linked to lower depression scores, suggesting a possible protective effect.

Why temperament matters more than a lab result (and what that changes)

A key psychological takeaway from this research paper is that emotional suffering in PHPT may be shaped as much by “who the person is emotionally” as by “what the blood test shows.” The study found no strong links between most biochemical measures and the severity of anxiety or depression symptoms. That doesn’t mean biology is irrelevant—PHPT is a biological condition—but it suggests that symptom severity isn’t simply a direct readout of calcium levels.

This fits with well-established psychological models. In diathesis–stress thinking, some people carry a vulnerability (a “diathesis”) that makes them more likely to develop symptoms when stress or illness hits. Affective temperament can be that vulnerability: a stable pattern that influences how strongly someone reacts to bodily sensations, uncertainty, and disruptions. PHPT can add plenty of triggers—fatigue, sleep changes, brain fog, medical appointments, and worries about surgery—yet not everyone responds emotionally the same way.

Consider two patients with similar medical profiles. One has prominent anxious temperament: they monitor every sensation, interpret a racing heart as danger, and search online late at night, escalating worry. Their anxiety climbs, and they start canceling plans because they feel “too keyed up.” The other leans hyperthymic: they still notice symptoms, but interpret them as temporary and keep routines intact; they’re more likely to seek support without spiraling. The illness is real for both, but temperament shapes the storyline their brain constructs around it.

The protective link with hyperthymic temperament also echoes research on positive affect and resilience. Optimism doesn’t erase symptoms, but it can reduce rumination, support active coping, and protect self-esteem—factors closely tied to depression risk. Importantly, the study does not claim temperament “causes” depression or anxiety; it shows meaningful associations and predictive patterns that can guide better screening and care.

How these findings can change care, communication, and daily coping

The phrase “The role of affective temperaments in predicting depression and anxiety symptoms in patients with primary hyperparathyroidism” has practical weight because it points to actions clinicians and patients can take—without waiting for symptoms to become severe.

In healthcare settings, adding a brief temperament-informed conversation can improve triage. If a PHPT patient shows strong anxious or cyclothymic traits, a clinician might proactively screen for anxiety and depression, normalize emotional reactions, and offer early support (psychoeducation, referral to therapy, or a collaborative care plan). This is especially useful when lab values don’t “explain” distress—reducing the risk that patients feel dismissed.

In therapy or counseling, temperament can guide the starting point. For anxious temperament, skills that target threat monitoring and worry—like cognitive-behavioral strategies, sleep routines, and interoceptive calming (breathing that reduces physical arousal)—may help quickly. For cyclothymic traits, therapy can focus on stabilizing routines: consistent sleep/wake times, tracking mood shifts, and planning for predictable dips (for example, not scheduling high-stakes work meetings on days after poor sleep). When irritable temperament is prominent, communication tools matter: short “repair” conversations after conflict, time-outs, and learning to label overstimulation before it turns into anger.

In workplaces and relationships, this research supports a simple shift: interpret emotional volatility as a signal, not a character flaw. A partner may take irritability personally, or a manager may read withdrawal as disengagement. Temperament-aware conversations (“I’m more reactive under uncertainty; can we make the plan clearer?”) can reduce friction and shame while encouraging accountability.

For patients themselves, temperament language can be relieving. It reframes symptoms from “I’m failing” to “my nervous system runs hot under stress.” That mindset supports earlier help-seeking and more self-compassion—both linked to better mental health outcomes.

The takeaway: screening for temperament can spot risk before suffering becomes the norm

This research paper makes a grounded, clinically useful point: PHPT is not only a hormone and calcium disorder; for many people it is also an emotional risk period, and affective temperaments help identify who is most likely to struggle with anxiety and depression symptoms. In this study, anxious and cyclothymic temperaments stood out as predictors of anxiety, while hyperthymic temperament appeared to buffer against depression.

The most memorable implication is also the most practical: when distress appears “out of proportion” to lab results, temperament may explain why—and it offers a roadmap for support. A good next question for clinicians and patients alike is simple: if we can predict emotional risk early, why wait for months of suffering before treating mental health as part of PHPT care?

Data in this article is provided by PLOS.

Tagged Anxiety, Anxiety disorders, Biochemistry, Clinical psychology, Cognitive neurology, Cognitive neuroscience, Cognitive psychology, Cognitive science, Depression, Emotions, Epidemiology, Hormones, Medical risk factors, Mental health and psychiatry, Mood disorders, Neurology, Neuropsychiatric disorders, Neuropsychological testing, Neuropsychology, Neuroscience, Neuroses, Parathyroid hormone, Psychological stress