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垂体腺瘤患者的个性特征表现为与焦虑相关的特质增加:70例肢端肥大症患者与无功能垂体腺瘤患者及年龄和性别匹配的对照组的比较。

Personality in patients with pituitary adenomas is characterized by increased anxiety-related traits: comparison of 70 acromegalic patients with patients with non-functioning pituitary adenomas and age- and gender-matched controls.

作者信息

Sievers C, Ising M, Pfister H, Dimopoulou C, Schneider H J, Roemmler J, Schopohl J, Stalla G K

机构信息

Department of Endocrinology, Max Planck Institute of Psychiatry, Munich, Germany.

出版信息

Eur J Endocrinol. 2009 Mar;160(3):367-73. doi: 10.1530/EJE-08-0896. Epub 2008 Dec 10.

Abstract

OBJECTIVE

Although neuropsychiatric and morphological brain alterations in acromegalic patients have been described and a distinct disease personality is clinically suspected, this has never been systematically investigated. We examined whether patients with acromegaly showed an altered personality profile compared with patients with non-functioning pituitary adenomas and healthy controls.

DESIGN AND METHODS

In this cross-sectional study, 70 acromegalic patients and 58 patients with non-functioning pituitary adenomas were compared with 140 mentally healthy population controls, matched for age and gender. Personality traits were measured by standardized personality questionnaires (Eysenck personality questionnaire-RK and tridimensional personality questionnaire).

RESULTS

Compared with healthy controls, acromegalic patients described themselves as distinctly more harm avoidant and neurotic and presented themselves with high social conformity. On harm avoidant subscales, they reported more anticipatory worries and pessimism, higher fear of uncertainty, higher fatigability and asthenia. This personality pattern was not specific for acromegaly, but could similarly be observed in patients with non-functioning pituitary adenomas. However, specific for patients with GH-producing adenomas was an even more reduced novelty-seeking behaviour, especially in terms of lower impulsiveness, compared with patients with non-functioning pituitary adenomas.

CONCLUSION

Patients with pituitary adenomas show a distinct pattern of increased anxiety-related personality traits compared with the general population, potentially as a result of the pituitary lesion and/or associated hormonal dysregulations and comorbidities. Acromegaly is additionally associated with reduced impulsivity and novelty-seeking behaviour, which might affect patients' management and their quality of life.

摘要

目的

尽管已描述了肢端肥大症患者的神经精神和脑形态学改变,且临床上怀疑存在独特的疾病人格,但从未对此进行过系统研究。我们研究了肢端肥大症患者与无功能性垂体腺瘤患者及健康对照相比,其人格特征是否有所改变。

设计与方法

在这项横断面研究中,将70例肢端肥大症患者和58例无功能性垂体腺瘤患者与140名年龄和性别匹配的精神健康人群对照进行比较。通过标准化人格问卷(艾森克人格问卷-RK和三维人格问卷)测量人格特质。

结果

与健康对照相比,肢端肥大症患者将自己描述为明显更具回避伤害性和神经质,且表现出高度的社会顺从性。在回避伤害性分量表上,他们报告有更多预期性担忧和悲观情绪,对不确定性的恐惧更高,疲劳感和虚弱感更强。这种人格模式并非肢端肥大症所特有,在无功能性垂体腺瘤患者中也同样可以观察到。然而,与无功能性垂体腺瘤患者相比,生长激素分泌型腺瘤患者的寻求新奇行为甚至更减少,尤其是在冲动性较低方面。

结论

与一般人群相比,垂体腺瘤患者表现出明显的与焦虑相关的人格特质增加模式,这可能是垂体病变和/或相关激素失调及合并症的结果。肢端肥大症还与冲动性和寻求新奇行为减少有关,这可能会影响患者的管理及其生活质量。

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