Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process

Exp Clin Endocrinol Diabetes. 2000;108(7):480-5. doi: 10.1055/s-2000-8144.

Abstract

A prospective study of 48 patients with pituitary adenomas, 19 adenomas causing Cushing's disease, 18 adenomas causing acromegaly, and 11 clinically hormone-inactive adenomas (inactive adenomas), was performed to study emotional disorders occurring before and after transsphenoidal microsurgery. Factors which led to an obvious delay in the diagnostic process were identified. - The tools utilised were an interview and repeated personality assessments. The personality assessments were begun preoperatively and continued for about half a year postoperatively. The interview data, including retrospective statements regarding somatic difficulties, was analysed. - The thesis of a uniform psychopathology due to the influence of elevated hormone levels, and a lack in patients' sensitivity towards their changed appearance in acromegaly could not be confirmed. A high variability of reported emotional problems was found. The most common psychopathological signs for Cushing's disease were excitability and depression, for acromegaly fatigue/loss of energy was the most frequent complaint. Six to eight months postoperatively, a majority of patients noticed an increase of physical well-being. In acromegaly, the time span between first consultation and diagnosis averaged 6.2 years, in Cushing's disease it was 4.3 years, and in inactive adenomas it was 3.9 years. Only a small part of the delay in diagnosis, less than two years, could be attributed to the patients' hesitation to consult a physician.

MeSH terms

  • Acromegaly / physiopathology
  • Acromegaly / psychology
  • Adenoma / diagnosis
  • Adenoma / physiopathology
  • Adenoma / psychology*
  • Adenoma / surgery
  • Adult
  • Emotions*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microsurgery
  • Middle Aged
  • Personality Inventory
  • Pituitary Neoplasms / diagnosis*
  • Pituitary Neoplasms / physiopathology
  • Pituitary Neoplasms / psychology*
  • Pituitary Neoplasms / surgery