Distinct Dopaminergic Personality Patterns in Patients with Prolactinomas: A Comparison with Nonfunctioning Pituitary Adenoma Patients and Age- and Gender-Matched Controls

Abstract

Introduction: Personality patterns such as extraversion and novelty seeking have been associated with an altered dopaminergic activity in healthy subjects. Patients with prolactinomas have been described as exhibiting an altered dopaminergic tone and are often treated with dopamine agonists. Little is known about the personality traits of this patient group. Hence, we aimed at examining whether patients with prolactinomas exhibit modified personality patterns compared to patients with nonfunctioning pituitary adenomas and healthy controls. Subjects/Methods: In this cross-sectional study, 86 patients with prolactinomas and 58 patients with nonfunctioning pituitary adenomas (NFPA) were compared with 172 mentally healthy age- and gender-matched controls. To assess personality traits, standardized personality questionnaires (Eysenck personality questionnaire-EPQ-RK and Tridimensional Personality Questionnaire devised by Cloninger-TPQ) were administered. Results: Patients with either prolactinomas or NFPA showed a distinct personality profile compared to the normal population, characterized by increased neuroticism and they also answered in a socially desirable mode. On harm-avoidant total and subscales, they presented with a higher fear of uncertainty and also increased fatigability and asthenia. The prolactinoma patients, when contrasted with the ‘clinical’ control group of patients with NFPA and after post hoc tests for multiple comparisons following the Bonferroni-Holm procedure showed significantly reduced extraversion (p = 0.044) and increased shyness with strangers (p = 0.044), tending to be more neurotic and present lower scores in the novelty seeking subscale impulsiveness. Conclusion: This is, to our knowledge, the first study providing new evidence of an altered personality profile of prolactinoma patients which might affect the patient-doctor relationship, treatment and patient’s quality of life.

Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas

“…Also for Cushing's disease, many studies have stressed that depression and anxiety-related personality disorders are common comorbidities in these patients (17,18,19,20,21). Patients with prolactinomas seem to experience increased neuroticism, high fear of uncertainty, and also increased fatigability and asthenia (22), but further studies are lacking. For patients with NFPAs, such data are still missing.…”

Clinical characteristics of pain in patients with pituitary adenomas

“…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).…”

Improving Quality of Life in Patients with Pituitary Tumours

“…19,[85][86][87] Gonadal dysfunction is one of the most important problems in these patients. In men, decreased libido, erectile dysfunction and poor seminal fluid quality are frequent consequences of prolactin hypersecretion.…”

“…In particular, prolactinoma patients presented minor extraversion, lesser novelty seeking, increased shyness and neuroticism compared with healthy controls. 87 Moreover, it has been shown that women treated for microprolactinomas were more vulnerable to anxiety and depression symptoms than control subjects. 86 Psychological support and psychiatric treatment may prevent and resolve these problems, since mental health is a major factor in perception of QoL.…”