Psychological complications in patients with acromegaly: relationships with sex, arthropathy, and quality of life

Abstract

Purpose Current treatment of acromegaly restores a normal life expectancy in most cases. So, the study of persistent complications affecting patients’ quality of life (QoL) is of paramount importance, especially motor disability and depression. In a large cohort of acromegalic patients we aimed at establishing the prevalence of depression, to look for clinical and sociodemographic factors associated with it, and to investigate the respective roles (and interactions) of depression and arthropathy in influencing QoL. Methods One hundred and seventy-one acromegalic patients (95 women and 76 men, aged 20–85 years) among those recruited in a cross-sectional Italian multicentric study were investigated. Each patient filled in three validated questionnaires: AcroQoL, WOMAC (measuring articular pain, stiffness and functionality), and AIMS (evaluating articular symptoms and depression). Results A very high (up to 28%) depression rate was detected in acromegalic subjects. Two patients showing pathological AIMS depression scores, committed suicide during the three years observational period. In our population poor psychological status was significantly associated with female sex. Furthermore, a significant strong correlation was found between AIMS depression score and WOMAC score. Both depression and arthropathy-related motor disability turned out to independently contribute with similar strength to the impairment of QoL. Conclusions We report a high prevalence of depression in acromegaly, which is associated with female sex and arthropathy. Both depression and arthropathy strongly and independently contribute to the impaired QoL of patients. Our study shows that assessment and monitoring of psychological status is mandatory in acromegaly, also suggesting an inexpensive tool for this assessment.

Impact of the diagnostic delay of acromegaly on bone health: data from a real life and long term follow-up experience

“…Our data can suggest a cumulative effect over time of the GH and IGF-1 hypersecretion on bone homeostasis, possibly explaining the effect of acromegaly diagnostic delay on the incidence of VFs rather than on their prevalence. In fact, to our knowledge, this study described for the first time that a diagnostic delay longer than 10 years is associated with an increased incidence of VFs, which were previously reported to be associated to a reduced quality of life and to the presence of hyperkyphosis [ 35 , 36 ]. In fact, thoracic hyperkyphosis may impair the cardiorespiratory function and predispose to worse outcome of pulmonary infections such as COVID-19 [ 37 ].…”

Allostatic Load and Endocrine Disorders

“…Quality of life is variably compromised in different endocrine diseases and does not necessarily improve with successful treatment and normalization of hormone values [14,36,39,[43][44][45][46][47][48]. Allostatic load may explain why treatments do not always yield the expected results or fail [49].…”

“…In recent years, there has been increasing awareness of the unsatisfactory degree of remission that current therapeutic strategies entail in a variety of endocrine disorders [14,36,[43][44][45][46][47][48]56]. There may be different reasons for a delayed or impaired process of recovery.…”

Impact of COVID-19 Pandemic on Disease Control Status and Quality of Life of Patients with Acromegaly

“…However, patients with acromegaly often face a poor quality of life (QoL) that is independent of biochemical disease control [1,2]. The frequently observed discordance between patient and clinician perception of the disease control status could be bridged using the new patientand clinician-reported outcome tools [3]. The clinician-reported outcome tools, such as the SAGIT instrument (SAGIT) and acromegaly disease activity tool (ACRODAT), provide an objective measure of present signs and symptoms, comorbidities, tumour profile, and biochemical parameters [4,5].…”