Prevalence of mental disorders in acromegaly: a cross‐sectional study in 81 acromegalic patients

Sievers, Caroline; Dimopoulou, Christina; Pfister, Hildegard; Lieb, Roselind; Steffin, B.; Roemmler, J.; Schopohl, Jochen; Mueller, Marianne; Schneider, Harald J.; Ising, Marcus; Wittchen, Hans‐Ulrich; Stalla, G. K.

doi:10.1111/j.1365-2265.2009.03555.x

Cited by 77 publications

(68 citation statements)

References 35 publications

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“…The emotional and psychological effects of such lingering changes have so far not been thoroughly studied. Previous studies have reported an increased risk of psychopathology and maladaptive personality traits in patients with active acromegaly and those who have been in long-term remission (8,21,22). However, to date there has been no satisfactory explanation of this phenomenon except that it may be related to irreversible changes associated with previous GH excess (8).…”

Section: Discussionmentioning

confidence: 77%

Morphometric changes correlate with poor psychological outcomes in patients with acromegaly

Imran

Tiemensma

Kaiser

et al. 2016

European Journal of Endocrinology

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Objective: Acromegaly is frequently associated with altered facial appearance at the time of diagnosis. Furthermore, acromegaly is also associated with adverse psychological outcomes. We conducted a single-centre, cross-sectional study comparing patients with growth hormone vs non-functioning pituitary adenomas (NFA) to assess the association between morphometric changes and psychological outcomes and illness perception of patients with acromegaly. Methods: A seven-step scale was developed to grade morphometric changes based on facial photographs. In addition, all patients were asked to draw an image of their own body and an image of what they considered to be an average healthy body and complete seven psychological questionnaires. We recruited 55 consecutive patients in each of the two groups who had undergone surgery with or without radiation therapy (RT). Results: Our data showed that the clinician-rated morphometric scale was highly reliable in assessing facial changes, with 93/99 (Intraclass correlation coefficient (ICC)Z0.95 (0.93-0.97)) graded as similar by independent raters. The mean (S.D.) grading for Acro and NFA patients on the clinician-rated morphometric scale were 3.5 (1.3) and 0.41 (0.35) respectively (P!0.0001). A higher clinician-rated morphometric score was also predictive of a poorer score on the drawing test. Conclusions: Our study demonstrates a correlation between physical changes associated with acromegaly and poor psychological outcomes, whereas no such correlation existed with modes of therapy, disease control status, RT, malignancy, initial or recent GH/IGF1 or secondary hormonal deficiency. Our data support the utility of the morphometric scale as a clinical tool for grading facial changes.

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Section: Discussionmentioning

confidence: 77%

Morphometric changes correlate with poor psychological outcomes in patients with acromegaly

Imran

Tiemensma

Kaiser

et al. 2016

European Journal of Endocrinology

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“…Patients with CD are frequently affected by major psychiatric disorders such as depression, anxiety and psychosis, even after long-term biochemical cure of the disease (8,9). Besides, there is an increased prevalence of affective disorders or anxiety-associated personality traits in patients with acromegaly and prolactinomas (10,11). Interestingly, patients with NFPA exhibited a comparable personality pattern, potentially as a result of the pituitary lesion and/or associated hormonal dysregulations (12).…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of pain in patients with pituitary adenomas

Dimopoulou

Athanasoulia

Hanisch

et al. 2014

European Journal of Endocrinology

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Objective: Clinical presentation of pituitary adenomas frequently involves pain, particularly headache, due to structural and functional properties of the tumour. Our aim was to investigate the clinical characteristics of pain in a large cohort of patients with pituitary disease. Design: In a cross-sectional study, we assessed 278 patients with pituitary disease (nZ81 acromegaly; nZ45 Cushing's disease; nZ92 prolactinoma; nZ60 non-functioning pituitary adenoma). Methods: Pain was studied using validated questionnaires to screen for nociceptive vs neuropathic pain components (painDETECT), determine pain severity, quality, duration and location (German pain questionnaire) and to assess the impact of pain on disability (migraine disability assessment, MIDAS) and quality of life (QoL). Results: We recorded a high prevalence of bodily pain (nZ180, 65%) and headache (nZ178, 64%); adrenocorticotropic adenomas were most frequently associated with pain (nZ34, 76%). Headache was equally frequent in patients with macroand microadenomas (68 vs 60%; PZ0.266). According to painDETECT, the majority of the patients had a nociceptive pain component (nZ193, 80%). Despite high prevalence of headache, 72% reported little or no headache-related disability (MIDAS). Modifiable factors including tumour size, genetic predisposition, previous surgery, irradiation or medical therapy did not have significant impact neither on neuropathic pain components (painDETECT) nor on headache-related disability (MIDAS). Neuropathic pain and pain-related disability correlated significantly with depression and impaired QoL.Conclusions: Pain appears to be a frequent problem in pituitary disease. The data suggest that pain should be integrated in the diagnostic and therapeutic work-up of patients with pituitary disease in order to treat them appropriately and improve their QoL.

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“…19 Long-standing exposure to IGF-1 and GH interferes with the regulation of trophic processes in many organ systems and is supposed to affect brain function and structures. 6 Several findings suggest that the GH has an important role during brain development.…”

Section: Discussionmentioning

confidence: 99%

“…5 In the literature, there is a limited study about structural and metabolic changes in the brains of patients with acromegaly. [5][6][7][8][9] Diffusionweighted imaging and diffusion tensor imaging (DTI) techniques provide microstructural information about biological tissue damage that cannot be obtained with other imaging modalities. 10 DTI has already improved the scientific understanding of many neurologic and psychiatric disorders.…”

mentioning

confidence: 99%

Microstructural brain changes in acromegaly: quantitative analysis by diffusion tensor imaging

Kılıçarslan¹,

İlhan²,

Alkan³

et al. 2014

BJR|case reports

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Prevalence of mental disorders in acromegaly: a cross‐sectional study in 81 acromegalic patients

Abstract: Acromegaly is associated with an increased prevalence and a specific pattern of affective disorders. Greater emphasis on diagnosing and treatment of mental disorders in acromegalic patients might improve the disease management.

Cited by 77 publications

References 35 publications

Morphometric changes correlate with poor psychological outcomes in patients with acromegaly

Morphometric changes correlate with poor psychological outcomes in patients with acromegaly

Clinical characteristics of pain in patients with pituitary adenomas

Microstructural brain changes in acromegaly: quantitative analysis by diffusion tensor imaging

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