IntroductionAcromegaly is a rare, severe, life-threatening disease, with mortality twice at that normal. It is characterized by increased and disregulated growth hormone (GH) production, usually caused by a GH-secreting pituitary tumor (somatotropinoma). Pituitary lesions are supposed to alter mood and personality.AimsTo assess point prevalence of mental disorders in patients with acromegaly.MethodsThis is a cross-sectional cohort study of 118 patients with acromegaly (aged 21-78 years) included into the Registry of acromegaly of the Moscow Region with total population of 7 million. All patients met international diagnostic criteria for acromegaly, including laboratory measurements and brain MRI. Mental disorders were diagnosed according to ICD-10 criteria; with additional use of MINI, Hypomania Checklist and cognitive battery.ResultsIn total mental disorders were found in 88/118 (74,6%) patients. 56% of all patients referred to cluster of organic mental disorders, including mild dementia, mood, anxiety, personality, asthenic and mild cognitive disorders. 4,2% had alcohol dependence, 5,1% - schizophrenia spectrum disorders. Affective disorders were diagnosed in 30%, including bipolar disorder II - 12,7%, cyclothymia - 5,1%. Neurotic, stress related and somatoform disorders were discovered in 12,7% of patients; personality disorder - in 1,7%. Mutual comorbidity among mental disorders reached 1,39.ConclusionStudy performed with the large sample of patients with acromegaly shows a higher prevalence of psychopathology. This fact evidence that patients with acromegaly need special mental care.The predominance of bipolar disorder with hypomania might be the result of stimulating effect of GH.Psychotic morbidity significantly exceeds that in total population, which can be explained by dysfunction of dopaminergic pathways.

Mental status and behavior were studied in 19 women aged 18-45 years with hyperprolactinemic hygonadism of different forms treated by selective dopamine receptor agonists (4 patients were treated with chinagolide and 15 with cabergolide). Appreciable improvement of the general clinical status was attained: biphasic menstrual cycle was restored, galactorrhea decreased, and prolactin level normalized. Sexual disorders and headaches reduced. Mental status improved: anxiety, depression, and severity of neurovegetative symptoms decreased. Hamilton score (anxiety) decreased from 16.5 to 9.1. Versatile personality investigation showed de creased profiles of the first, third, seventh, and eighth scales, which indicates decreased affective strain, reduction of psychological partitioning and sense of one's own inadequacy, and decreased liability to exert psychological pressure on other people by means of somatic symptoms available. However, these positive shifts in the mental status of patients were insufficiently complete and stable, despite the continuing decrease in prolactin level.

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Primary hyperprolactinemia (PHP) is one of the principal causes of female sterility. Fifty-three women with pathologic hyperprolactinemia of various origins were examined. A high incidence of combination of PHP with mental disorders - up to 70% - was revealed. Despite comparative polymorphism and the nonspecific type of psychopathologic disturbances proper in different variants of primary hyperprolactinemia, women with the primary hyperprolactinemia syndrome develop similar personality characteristics, e.g. constellations of such features as conservatism, altruism, self-sufficiency, autism. The said constellation appears to reflect the pathological shifts in the brain systems of patients with PHP, which are related to the development of the adaptive forms of maternal behavior in the period of breastfeeding.