Depressive symptoms in acromegaly: factors that affect their incidence and severity?
DOI:
https://doi.org/10.20883/medical.e453Keywords:
depression, acromegaly, BDI-II, Beck Depression Inventory-IIAbstract
Aim. The study aimed to evaluate the influence of acromegaly on the prevalence and the severity of depressive symptoms in patients with active and inactive disease.
Material and Methods. The study group comprised 56 patients with acromegaly, which were divided into two groups based on growth hormone (GH) and insulin-like growth factor (IGF-1) levels, with controlled/cured and with uncontrolled acromegaly. The presence and severity of depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II).
Results. The mean score of BDI-II in the whole group of patients was 13.43±10.41, with no significant difference in the severity of depressive symptoms between patients with cured/controlled and uncontrolled acromegaly (p=0.620). Similarly, the lack of statistically significant differences was confirmed in patients with micro- and macroadenomas, as well as with and without hypopituitarism. There were no significant correlations between BDI-II scores and GH or IGF-1 levels, patient age or duration of the illness.
Conclusions. Depressive symptoms are common in acromegalic patients even if remission has been attained. They are most likely caused by psychological, non-organic causes. Patients diagnosed with acromegaly should undergo a screening BDI test as a part of comprehensive care, and in the event of elevated levels should be provided with a psychiatric consultation and psychological care.
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Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A. High Prevalence of Pituitary Adenomas: A Cross-Sectional Study in the Province of Liège, Belgium. The Journal of Clinical Endocrinology & Metabolism. 2006 Dec 1;91(12):4769-4775. https://doi.org/10.1210/jc.2006-1668
Fernandez A, Karavitaki N, Wass JAH. Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clinical Endocrinology. 2010 Mar;72(3):377-382. https://doi.org/10.1111/j.1365-2265.2009.03667.x
Colao A, Ferone D, Marzullo P, Lombardi G. Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management. Endocrine Reviews. 2004 Feb 1;25(1):102-152. https://doi.org/10.1210/er.2002-0022
Melmed S. Acromegaly. New England Journal of Medicine. 2006 Dec 14;355(24):2558-2573. https://doi.org/10.1056/nejmra062453
Bolanowski M, Ruchała M, Zgliczyński W, Kos-Kudła B, Hubalewska-Dydejczyk A, Lewiński A. Diagnostics and treatment of acromegaly - updated recommendations of the Polish Society of Endocrinology. Endokrynol Pol.. 2019;70(1):2-18. https://doi.org/10.5603/EP.a2018.0093
Celik O, Kadioglu P. Quality of life in female patients with acromegaly. Journal of Endocrinological Investigation. 2013 Jun;36(6). https://doi.org/10.3275/8761
Celik O, Hatipoglu E, Akhan SE, Uludag S, Kadioglu P. Acromegaly is associated with higher frequency of female sexual dysfunction: experience of a single center. Endocrine Journal. 2013;60(6):753-761. https://doi.org/10.1507/endocrj.ej12-0424
T’Sjoen G, Bex M, Maiter D, Velkeniers B, Abs R. Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian Registry on acromegaly. European Journal of Endocrinology. 2007 Oct;157(4):411-417. https://doi.org/10.1530/eje-07-0356
Webb SM. Quality of Life in Acromegaly. Neuroendocrinology. 2006;83(3-4):224-229. https://doi.org/10.1159/000095532
Webb SM, Badia X. Quality of Life in Growth Hormone Deficiency and Acromegaly. Endocrinology and Metabolism Clinics of North America. 2007 Mar;36(1):221-232. https://doi.org/10.1016/j.ecl.2006.11.011
Åberg ND, Brywe KG, Isgaard J. Aspects of Growth Hormone and Insulin-Like Growth Factor-I Related to Neuroprotection, Regeneration, and Functional Plasticity in the Adult Brain. The Scientific World JOURNAL. 2006;6:53-80. https://doi.org/10.1100/tsw.2006.22
Martín-Rodríguez JF, Madrazo-Atutxa A, Venegas-Moreno E, Benito-López P, Gálvez MÁ, Cano DA, Tinahones FJ, Torres-Vela E, Soto-Moreno A, Leal-Cerro A. Neurocognitive Function in Acromegaly after Surgical Resection of GH-Secreting Adenoma versus Naïve Acromegaly. Wolfe A. PLoS ONE. 2013 Apr 4;8(4):e60041. https://doi.org/10.1371/journal.pone.0060041
Smarr KL, Keefer AL. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionna. Arthritis Care & Research. 2011 Nov;63(S11):S454-S466. https://doi.org/10.1002/acr.20556
Wciórka J, Pużyński S. Narzędzia oceny stanu psychicznego. In: Rybakowski J, Pużyński S, Wciórka J, eds. Psychiatria. Podstawy psychiatrii. 1. Wrocław: Elsevier Urban & Partner; 2010:455-6.
Zawadzki B, Popiel A, Pragłowska E. Charakterystyka psychometryczna polskiej adaptacji Kwestionariusza Depresji BDI-II Aarona T. Becka. Psychol Etol Genet. 2009;19:71-95.
Oleszko A, Szczepańska E, Janion K, Jośko-Ochojska J. Nutrition behaviours and the occurrence of depressive symptoms among the students in the institutions of higher education in Silesia (Poland). Roczniki Państwowego Zakładu Higieny. 2019;:69-77. https://doi.org/10.32394/rpzh.2019.0056
Bleuler M. The psychopathology of acromegaly. J Nerv Ment Diseases.1951(113):497-511.
Michael R, Gibbons J. Inter-relationships between the endocrine system and neuropsychiatry. Int Rev Neurobiol. 1963;5:243-302. https://doi.org/10.1016/s0074-7742(08)60597-8
Beumont P. Endocrines and psychiatry. Br J Hosp Med. 1972;7:485-97.
Avery TL. A Case of Acromegaly and Gigantism with Depression. British Journal of Psychiatry. 1973 May;122(570):599-600. https://doi.org/10.1192/bjp.122.5.599
Labhart A. Clinical Endocrinology. 1. Berlin-Heidelberg: Springer-Verlag Berlin-Heidelberg; 1974. https://doi.org/10.1007/978-3-642-96158-8
Margo A. Acromegaly and Depression. British Journal of Psychiatry. 1981 Nov;139(5):467-468. https://doi.org/10.1192/bjp.139.5.467
Lishman W. Organic psychiatry, the psychological consequences of cerebral disorders. 2. London: Blackwell Scientific Publications; 1987.
Kuśmierek M, Florkowski A, Gałecki P, Talarowska M. Comorbidity of psychiatric and somatic disorders among patients diagnosed with depression. Curr Probl Psych. 2011;12(3):285-92.
Ryszard Piotrowicz, Joanna Potocka, Aleksander Araszkiewicz, Marcin Wojnar, Dorota Nawacka-Pawlaczyk. Depresja jako problem kardiologiczny w praktyce lekarzy podstawowej opieki zdrowotnej. Folia Cardiologica Excerpta. 2003;10(2):177-84.
Hajduk A, Korzonek M, Przybycień K, Ertmański S, Stolarek J. Badanie depresyjności skala depresji Becka u pacjentów z zaburzeniami rytmu serca [Study of depressiveness with Beck Depression Inventory in patients with cardiac arrhythmias]. Ann Acad Med Stetin. 2011;57(1):45-8. PMID 22593990
Bokma WA, Batelaan NM, van Balkom AJ, Penninx BW. Impact of Anxiety and/or Depressive Disorders and Chronic Somatic Diseases on disability and work impairment. Journal of Psychosomatic Research. 2017 Mar;94:10-16. https://doi.org/10.1016/j.jpsychores.2017.01.004
Szpakowski N, Bennell MC, Qiu F, Ko DT, Tu JV, Kurdyak P, Wijeysundera HC. Clinical Impact of Subsequent Depression in Patients With a New Diagnosis of Stable Angina. Circulation: Cardiovascular Quality and Outcomes. 2016 Nov;9(6):731-739. https://doi.org/10.1161/circoutcomes.116.002904
Dudek D, Sobański JA. Mental disorders in somatic diseases: psychopathology and treatment. Polish Archives of Internal Medicine. 2012 Nov 18;122(12):624-629. https://doi.org/10.20452/pamw.1539
Dudek D, Siwek M. Depression in medical illness. Psychiatria. 2007;4(1):17-24.
Whisman MA, Perez JE, Ramel W. Factor structure of the Beck Depression Inventory—Second Edition (BDI-ii) in a student sample. Journal of Clinical Psychology. 2000 Apr;56(4):545-551. https://doi.org/10.1002/(sici)1097-4679(200004)56:4<545::aid-jclp7>3.0.co;2-u
Lopuszańska M, Szklarska A, Jankowska E. Ocena nasilenia objawów depresyjnych z zastosowaniem polskiej wersji IA Inwentarza Depresji Becka u zdrowych mezczyzn, mieszkańców Wrocławia [Assessment of severity of depressive symptoms using the Polish version IA of Beck Depression Inventory in healthy men, inhabitants of Wrocław]. Psychiatr Pol. 2013 Nov-Dec;47(6):1001-9. PMID 25007533
Crespo I, Santos A, Valassi E, Pires P, Webb SM, Resmini E. Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly. Endocrine. 2015 May 28;50(3):756-763. https://doi.org/10.1007/s12020-015-0634-6
Pantanetti P, Sonino N, Arnaldi G, Boscaro M. Self image and quality of life in acromegaly. Pituitary. 2002;5:17-9. https://doi.org/10.1023/a:1022145116901
Furman K, Ezzat S. Psychological Features of Acromegaly. Psychotherapy and Psychosomatics. 1998;67(3):147-153. https://doi.org/10.1159/000012275
Biermasz NR, Pereira AM, Smit JWA, Romijn JA, Roelfsema F. Morbidity after Long-Term Remission for Acromegaly: Persisting Joint-Related Complaints Cause Reduced Quality of Life. The Journal of Clinical Endocrinology & Metabolism. 2005 May;90(5):2731-2739. https://doi.org/10.1210/jc.2004-2297
Geraedts VJ, Dimopoulou C, Auer M, Schopohl J, Stalla GK, Sievers C. Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life. Frontiers in Endocrinology. 2015 Jan 6;5. https://doi.org/10.3389/fendo.2014.00229
De Sousa A. Depression in Acromegaly Treated with Escitalopram and Cognitive Therapy. Indian Journal of Psychological Medicine. 2009 Jan;31(1):50-51. https://doi.org/10.4103/0253-7176.53317
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Copyright (c) 2020 Adam Malicki, Joanna Malicka, Emilia Potembska, Agnieszka Zwolak, Dariusz Malicki, Patrycja Rogowska
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