Evaluation of depression, quality of life and body image in patients with Cushing’s disease

Alçalar, Nilüfer; Özkan, Sedat; Kadıoğlu, Pınar; Çelik, Özlem; Çağatay, Penbe; Küçükyürük, Barış; Gazioğlu, Nurperi

doi:10.1007/s11102-012-0425-5

Cited by 87 publications

(28 citation statements)

References 33 publications

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“…Using the Beck Depression Inventory II (BDI-II), the SF-36 and the Multidimensional Body-Self Relations Questionnaire (MBSRQ), it was found that QoL in the general health category and perception of body image were worse in 40 patients with CD who underwent transsphenoidal surgery, compared to 40 healthy controls (68). In contrast with several other studies however no differences in depression scores were found between CD patients globally and controls.…”

Section: Cushing's Diseasementioning

confidence: 81%

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

Webb

Crespo

Santos

et al. 2017

European Journal of Endocrinology

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Background: In the last few years, quality of life (QoL) has become an outcome measure in patients with pituitary diseases. Objective: To describe the available data on QoL impairment evaluated with questionnaires in patients with pituitary diseases. Design: Critical review of the pertinent literature and pragmatic discussion of available information. Methods: Selection of relevant literature from PubMed and WOK, especially from the last 5 years and comprehensive analysis. Results: QoL is impaired in all pituitary diseases, mostly in acromegaly and Cushing's disease (similar to other causes of Cushing's syndrome), but also in non-functioning pituitary adenomas and prolactinomas, especially in the active phase of the disease. Nevertheless, even after endocrine 'cure', scores tend to be below normative values, indicative of residual morbidity after hormonal control. The presence of hypopituitarism worsens subjective QoL perception, which can improve after optimal substitution therapy, including recombinant human growth hormone, when indicated. Conclusions: To improve the long-term outcome of pituitary patients, helping them to attain the best possible health, it appears desirable to include subjective aspects captured when evaluating QoL, so that the affected dimensions are identified and if relevant treated. Additionally, being aware that treatment outcome may not always mean complete normalisation of physical and mental issues related to QoL can be a first step to adaptation and conforming to this new status.

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Section: Cushing's Diseasementioning

confidence: 81%

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

Webb

Crespo

Santos

et al. 2017

European Journal of Endocrinology

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“…Therefore, dysfunction in this area is hypothesized to be related to mood and anxiety disorders, 7 which are common symptoms in patients with CD. 1,27,35,36 Major depressive disorder is the most common and severe psychiatric disorder associated with chronic endogenous hypercortisolism. A recent review by Pivonello and colleagues shows a prevalence of major depressive disorder in 50%-81% of patients with CS.…”

Section: Discussionmentioning

confidence: 99%

Hippocampal and cerebellar atrophy in patients with Cushing’s disease

Burkhardt¹,

Lüdecke

Spies

et al. 2015

FOC

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OBJECT Cushing’s disease (CD) may cause atrophy of different regions of the human brain, mostly affecting the hippocampus and the cerebellum. This study evaluates the use of 3-T MRI of newly diagnosed patients with CD to detect atrophic degeneration with voxel-based volumetry. METHODS Subjects with newly diagnosed, untreated CD were included and underwent 3-T MRI. Images were analyzed using a voxelwise statistical test to detect reduction of brain parenchyma. In addition, an atlas-based volumetric study for regions likely to be affected by CD was performed. RESULTS Nineteen patients with a mean disease duration of 24 months were included. Tumor markers included adre-nocorticotropic hormone (median 17.5 pmol/L), cortisol (949.4 nmol/L), and dehydroepiandrosterone sulfate (5.4 μmol/L). The following values are expressed as the mean ± SD. The voxelwise statistical test revealed clusters of significantly reduced gray matter in the hippocampus and cerebellum, with volumes of 2.90 ± 0.26 ml (right hippocampus), 2.89 ± 0.28 ml (left hippocampus), 41.95 ± 4.67 ml (right cerebellar hemisphere), and 42.11 ± 4.59 ml (left cerebellar hemisphere). Healthy control volunteers showed volumes of 3.22 ± 0.25 ml for the right hippocampus, 3.23 ± 0.25 ml for the left hippocampus, 50.87 ± 4.23 ml for the right cerebellar hemisphere, and 50.42 ± 3.97 ml for the left cerebellar hemisphere. CONCLUSIONS Patients with untreated CD show significant reduction of gray matter in the cerebellum and hippocampus. These changes can be analyzed and objectified with the quantitative voxel-based method described in this study.

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“…Using the Beck Depression Inventory II (BDI-II), the SF-36 and the multidimensional body-self relations questionnaire (MBSRQ), QoL in the general health category and perception of body image were worse in 40 patients with CD who underwent transsphenoidal surgery, compared to 40 healthy controls [28]. In contrast with several other studies, however, no differences in depression scores were found between CD patients globally and controls.…”

Section: Psychological Consequences Of Cushing's Syndromementioning

confidence: 80%

Quality of Life in Cushing's disease: A long term issue?

Webb

Santos

Resmini

et al. 2018

Annales d'Endocrinologie

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The purpose of this review is to describe how quality of life (QoL) is impaired in patients with hypercortisolism due to Cushing's syndrome of any aetiology, including pituitary-dependent Cushing's disease. It is worse in active disease, but improvement after successful therapy is often incomplete, due to persistent physical and psychological co-morbidities, even years after endocrine "cure". Physical symptoms like extreme fatigability, central obesity with limb atrophy, hypertension, fractures, and different skin abnormalities severely impair the affected patients' everyday life. Psychological and cognitive problems like bad memory, difficulties to concentrate and emotional distress, often associated with anxiety and depression, make it difficult for many patients to overcome the aftermath of treated Cushing's syndrome. Recent studies have shown diffuse structural abnormalities in the central nervous system during active hypercortisolism, thought to be related to the wide distribution of glucocorticoid receptors throughout the brain. Even though they improve after treatment, normalization is often not complete. Shortening the exposure to active Cushing's syndrome by reducing the often long delay to diagnosis and promptly receiving effective treatment is highly desirable, together with preparing the patient for the difficult periods, especially after surgery. In this way they are prepared for the impairments they perceive in every day life, and live with the hope of later improvement, which can be therapeutic in many instances.

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Evaluation of depression, quality of life and body image in patients with Cushing’s disease

Cited by 87 publications

References 33 publications

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

Hippocampal and cerebellar atrophy in patients with Cushing’s disease

Quality of Life in Cushing's disease: A long term issue?

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