垂体腺瘤患者睡眠质量降低和抑郁与生活质量下降相关。
Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas.
作者信息
Leistner Sarah M, Klotsche Jens, Dimopoulou Christina, Athanasoulia Anastasia P, Roemmler-Zehrer Josefine, Pieper Lars, Schopohl Jochen, Wittchen Hans-Ulrich, Stalla Günter K, Fulda Stephany, Sievers Caroline
机构信息
Department of EndocrinologyMax-Planck-Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, GermanyInstitute of Clinical Psychology and PsychotherapyCenter of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, GermanyMedizinische Klinik InnenstadtLudwig-Maximilians University, Ziemssenstraße 1, 80336 Munich, GermanySleep and Epilepsy CenterNeurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Via Tesserete 46, 6900 Lugano, SwitzerlandA Leibnitz InstituteGerman Rheumatism Research Center, Charitéplatz 1, 10117 Berlin, Germany
Department of EndocrinologyMax-Planck-Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, GermanyInstitute of Clinical Psychology and PsychotherapyCenter of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, GermanyMedizinische Klinik InnenstadtLudwig-Maximilians University, Ziemssenstraße 1, 80336 Munich, GermanySleep and Epilepsy CenterNeurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Via Tesserete 46, 6900 Lugano, SwitzerlandA Leibnitz InstituteGerman Rheumatism Research Center, Charitéplatz 1, 10117 Berlin, Germany Department of EndocrinologyMax-Planck-Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, GermanyInstitute of Clinical Psychology and PsychotherapyCenter of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, GermanyMedizinische Klinik InnenstadtLudwig-Maximilians University, Ziemssenstraße 1, 80336 Munich, GermanySleep and Epilepsy CenterNeurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Via Tesserete 46, 6900 Lugano, SwitzerlandA Leibnitz InstituteGerman Rheumatism Research Center, Charitéplatz 1, 10117 Berlin, Germany.
出版信息
Eur J Endocrinol. 2015 Jun;172(6):733-43. doi: 10.1530/EJE-14-0941. Epub 2015 Mar 19.
OBJECTIVES
Several studies reported decreased quality of life (QoL) and sleep as well as increased rates of depression for patients with pituitary adenomas. Our aim was to explore to what extent differences in depression and sleep quality contribute to differences in QoL between patients with pituitary adenomas and controls.
DESIGN
A cross-sectional case-control study.
SETTING
Endocrine Outpatient Unit of the Max Planck Institute of Psychiatry, Munich, Department of Internal Medicine, Ludwig-Maximilians-University, Munich, and the Institute of Clinical Psychology and Psychotherapy, Technical University, Dresden.
PARTICIPANTS
Patients with pituitary adenomas (n=247) and controls (from the DETECT cohort, a large epidemiological study in primary care patients) matched individually by age and gender (n=757).
MEASUREMENTS
Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and QoL was measured by the generic EQ-5D and calculated by the time trade-off- and VAS-method. Depression was categorized as 'no depression', 'subclinical depression', and 'clinical depression' according to the Beck Depressions Inventory for patients and the Depression Screening Questionnaire for control subjects.
STATISTICAL ANALYSES
General linear and generalized, logistic mixed models as well as proportional odds mixed models were calculated for analyzing differences in baseline characteristics and in different subgroups.
RESULTS
Patients with pituitary adenomas showed decreased QoL (VAS index: 0.73±0.19) and sleep (PSQI score: 6.75±4.17) as well as increased rates of depression (subclinical or clinical depression: 41.4%) compared with their matched control subjects (VAS index: 0.79±0.18, PSQI score: 5.66±4.31, subclinical or clinical depression: 25.9%). We have shown that a substantial proportion of the reduced QoL (48% respectively 65%) was due to the incidence of depression and reduced sleep quality.
CONCLUSIONS
These findings emphasize the importance of diagnosing depressive symptoms and sleep disturbances in patients with pituitary disease, with the ultimate goal to improve QoL in patients with pituitary adenomas.
目的
多项研究报告称，垂体腺瘤患者的生活质量（QoL）和睡眠质量下降，抑郁症发病率增加。我们的目的是探讨抑郁症和睡眠质量的差异在多大程度上导致垂体腺瘤患者与对照组之间生活质量的差异。
设计
一项横断面病例对照研究。
地点
慕尼黑马克斯·普朗克精神病学研究所内分泌门诊、慕尼黑路德维希 - 马克西米利安大学内科、德累斯顿工业大学临床心理学与心理治疗研究所。
参与者
垂体腺瘤患者（n = 247）和对照组（来自DETECT队列，一项针对初级保健患者的大型流行病学研究），按年龄和性别进行个体匹配（n = 757）。
测量方法
采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量，用通用的EQ - 5D测量生活质量，并通过时间权衡法和视觉模拟评分法（VAS）计算。根据患者的贝克抑郁量表和对照受试者的抑郁筛查问卷，将抑郁症分为“无抑郁”、“亚临床抑郁”和“临床抑郁”。
统计分析
计算一般线性模型、广义线性模型、逻辑混合模型以及比例优势混合模型，以分析基线特征和不同亚组之间的差异。
结果
与匹配的对照受试者相比，垂体腺瘤患者的生活质量（VAS指数：0.73±0.19）和睡眠质量（PSQI评分：6.75±4.17）下降，抑郁症发病率增加（亚临床或临床抑郁：41.4%）（VAS指数：0.79±0.18，PSQI评分：5.66±4.31，亚临床或临床抑郁：25.9%）。我们发现，生活质量下降的很大一部分（分别为48%和65%）是由于抑郁症的发生和睡眠质量下降。
结论
这些发现强调了在垂体疾病患者中诊断抑郁症状和睡眠障碍的重要性，最终目标是改善垂体腺瘤患者的生活质量。
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