Sonino Nicoletta, Bonnini Stefano, Fallo Francesco, Boscaro Marco, Fava Giovanni A
Department of Statistical Sciences, University of Padova, Italy.
Clin Endocrinol (Oxf). 2006 Mar;64(3):314-8. doi: 10.1111/j.1365-2265.2006.02462.x.
Psychological distress does not always disappear upon proper endocrine treatment of Cushing's syndrome, and quality of life may still be compromised. Little is known on the personality correlates that may be involved. The aim of this study was to provide a controlled assessment of personality characteristics and quality of life in patients successfully treated for Cushing's syndrome.
A single-centred, controlled, prospective study.
Twenty-four consecutive outpatients who were in remission upon proper treatment of Cushing's syndrome for at least 1 year and no more than 3 years (20 with pituitary-dependent Cushing's disease and four with a cortisol-secreting adrenal adenoma; 5 M/19 F; mean age 34.5, SD = 10.6; range 18-57 years) were compared with 24 healthy control subjects matched for sociodemographic variables.
Both patients and controls were administered two self-rating scales: (a) tridimensional personality questionnaire (TPQ), a 100-item inventory that yields three scales: novelty seeking, harm avoidance and reward dependence. (b) symptom rating test (SRT), a 46-item scale for assessing psychological distress and quality of life with six subscales (anxiety, depression, somatic symptoms, anger-hostility, cognitive symptoms, psychotic symptoms).
There were no significant differences in personality dimensions, as measured by the TPQ, between patients and controls. The results did not change when the four patients with an adrenal adenoma were excluded and only the 20 with pituitary-dependent Cushing's disease were considered. As to the SRT scale, patients with Cushing's syndrome displayed significantly higher scores in anxiety (P= 0.046), depression (P= 0.013), and psychotic symptoms (P= 0.006), with a generalized compromised quality of life (P= 0.02). Again, no differences were found in evaluating the 20 patients with Cushing's disease separately.
Even though personality traits other than those explored here may be involved, the results seem to exclude the presence of latent dysfunctional attitudes and beliefs contributing to long-standing psychological disturbances, even in the pituitary-dependent form of Cushing's syndrome. Data from larger populations might provide further insight in this field. The findings of a compromised quality of life are in agreement with the recent literature and have implications for the long-term management of patients.
库欣综合征经适当的内分泌治疗后，心理困扰并非总会消失，生活质量仍可能受到影响。对于可能涉及的人格相关性因素，人们了解甚少。本研究的目的是对成功治疗库欣综合征的患者的人格特征和生活质量进行对照评估。
一项单中心、对照、前瞻性研究。
24例连续门诊患者，经适当治疗库欣综合征缓解至少1年且不超过3年（20例垂体依赖性库欣病患者和4例分泌皮质醇的肾上腺腺瘤患者；5例男性/19例女性；平均年龄34.5岁，标准差 = 10.6；年龄范围18 - 57岁），与24名在社会人口统计学变量上匹配的健康对照者进行比较。
患者和对照者均接受两种自评量表测试：（a）三维人格问卷（TPQ），这是一份100项的量表，产生三个分量表：寻求新奇、避免伤害和奖赏依赖。（b）症状评定测试（SRT），一份46项的量表，用于评估心理困扰和生活质量，有六个子量表（焦虑、抑郁、躯体症状、愤怒 - 敌意、认知症状、精神病性症状）。
通过TPQ测量，患者和对照者在人格维度上无显著差异。排除4例肾上腺腺瘤患者，仅考虑20例垂体依赖性库欣病患者时，结果未改变。至于SRT量表，库欣综合征患者在焦虑（P = 0.046）、抑郁（P = 0.013）和精神病性症状（P = 0.006）方面得分显著更高，生活质量普遍受损（P = 0.02）。同样，单独评估20例库欣病患者时未发现差异。
尽管可能涉及此处未探讨的人格特质，但结果似乎排除了存在导致长期心理障碍的潜在功能失调态度和信念，即使在垂体依赖性库欣综合征中也是如此。来自更大样本的数据可能会在该领域提供进一步的见解。生活质量受损的研究结果与近期文献一致，对患者的长期管理具有重要意义。
