PURPOSE: Depression and anxiety are the main disorders in patients suffering from hypothyroidism. These disorders can lead to increased patient suffering. Since hypothyroidism is one of the most prevalent endocrine diseases, controlling the metabolic variables that increase the severity of anxiety and depression is important. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors, including metabolic variables, among people with hypothyroidism. PATIENTS AND METHODS: We performed a cross-sectional study of 1,600 patients with hypothyroidism in Kerman, the southern part of Iran. The prevalence of depression and anxiety was estimated using the Beck Depression Inventory and the Hamilton Anxiety questionnaires, respectively. First, univariate logistic regression was performed. Factors whose P-values were smaller than 0.2 in univariate logistic regression were included in multiple logistic regression for confounder adjustments. The analysis was performed using SPSS version 20. RESULTS: The rates of depression and anxiety were 59% (95% CI: 53.18-62.11) and 63% (95% CI: 58.42-67.22), respectively. Factors found to be independently associated with anxiety were high TSH, high LDL, high TG, high FBS, high TGAb, high TPoAb, high TC, and hypertension. For depression, high TSH, high LDL, high TG, high FBS, high TC, and hypertension were identified. High TGAb and high TPoAb were independently associated with anxiety but not with depression. CONCLUSIONS: Study findings revealed that a large proportion of patients with hypothyroidism suffer from depression and anxiety. This study also identified factors associated with these disorders. Controlling some metabolic variables may decrease the prevalence and severity of these disorders, help patients with better treatment, and improve their quality of life.