Pre- and Postoperative Health Status of Patients with Nonfunctioning and Secretory Pituitary Adenomas and an Analysis of Related Factors

Abstract

Purpose. To identify the characteristics of the physical and mental health status of patients with pituitary adenomas, explore the postoperative reversibility of impaired health status, and assess the impact of clinical characteristics, hormone levels, anxiety, depression, and disease stigma on health status. Methods. We prospectively enrolled 147 and 138 patients with nonfunctioning and secretory pituitary adenomas, respectively. Health status was evaluated in 8 domains using the 36-item Short-Form Health Survey before and 3 months after transsphenoidal surgery. The Self-Rating Anxiety Scale, the Self-Rating Depression Scale, and the Stigma Scale for Chronic Illness were used to assess the psychological status. Results. Compared with the healthy population reference values, general physical and mental health, social functioning, and role limitations due to physical and psychological health problems were all found to be significantly impaired in the adenoma patients. Health status was worse in patients with adrenocorticotropic hormone- (ACTH-) secreting and growth hormone- (GH-) secreting adenomas than in patients with nonfunctioning adenomas. Among the patients, 11.6% had anxiety and 30.9% had depression. Higher scores for anxiety, depression, and disease stigma; older age; higher body mass index; and tumor recurrence were independent risk factors for health status impairment in at least one domain. Physical function impairment and role limitations caused by physical health problems became worse after surgery, whereas the mental component of health status remained the same. Conclusion. Health status was impaired in patients with pituitary adenomas, especially secretory adenomas. Physical function and role limitations were worse 3 months after surgery than before surgery. Mental problems, old age, obesity, and tumor recurrence reduced health status.

Opioid use after endoscopic skull base surgery: A descriptive, prospective, longitudinal cohort study

“…Increased duration of opioid use was also associated with a history of anxiety and depression. Compared with the healthy population, patients with pituitary adenomas have higher rates of anxiety and depression than the general population, and these illnesses persist even after surgical intervention 15,16 . Similarly, patients with other anterior skull base neoplasms, such as meningiomas and olfactory neuroblastoma, also have increased rates of comorbid anxiety and depression 17,18 .…”

“…Compared with the healthy population, patients with pituitary adenomas have higher rates of anxiety and depression than the general population, and these illnesses persist even after surgical intervention. 15,16 Similarly, patients with other anterior skull base neoplasms, such as meningiomas and olfactory neuroblastoma, also have increased rates of comorbid anxiety and depression. 17,18 This higher prevalence of anxiety and depression in the ESBS population may influence postoperative opioid use.…”

Fatigue and Its Contributing Factors in Chinese Patients with Primary Pituitary Adenomas

“…Numerous emotional issues, such as anxiety, depression, behavioral disorders, and personality changes, may be linked to pituitary illnesses [ 44 ]. A previous study reported that 11.6% of PA patients had anxiety, and 30.9% had depression [ 45 ]. A study from Canada found that almost 40% of participants had clinically significant symptoms of depression.…”

Prevalence, correlations, and impact of sleep disturbance in Chinese patients with primary pituitary adenomas

“…patients suffer from more general symptoms, such as headache, fatigue, anxiety, and depression [6,7]. The appearance of these symptoms may lead to the quality of life impaired [8,9].…”

“…The results emphasize the importance of fatigue and alcohol use in the sleep disturbance of PA patients. Medical personnel should pay more attention to PA patients with sleep disturbance before the initial diagnosis and preparation for surgery in order to take effective measures early to improve sleep disturbance, with the ultimate goal to improve their QoL.patients suffer from more general symptoms, such as headache, fatigue, anxiety, and depression [6,7]. The appearance of these symptoms may lead to the quality of life impaired [8,9].Sleep is one of the basic and indispensable activities of daily life that affect individual health and quality of life.…”