Psychopathology in Acromegaly—Real and Perceived

Abstract

Acromegaly is a chronic condition caused by the excessive production of growth hormone and is characterized by progressive morphological and systemic complications, as well as increased prevalence of psychopathologies, which markedly affect patients’ quality of life. The advancing multimodal therapies, while significantly improving the morbidity and mortality, has limited impact on psychopathologies, which often persist despite disease remission. The most common psychopathologies in acromegaly include depression, anxiety and affective disorders, together with sexual dysfunction, which may be considered as either a consequence or potentially even a contributory factor to these psychopathologies. Approximately one third of acromegaly patients manifest depression, whereas two thirds of patients display anxiety, with both conditions tending to be more prevalent and severe in younger patients with shorter duration of disease. Apparently, a major impact of psychological discomfort in women compared to men appears to be the fact that women tend to internalize whereas men tend to externalize their distress. The personality disorders also commonly associated with acromegaly, especially due to body image suffering, is linked to sexual dysfunction, which seems to affect women more than men. In summary, psychopathology in acromegaly is a major determinant of the quality of life and a complex array of psychological abnormalities are associated with acromegaly.