Section of Endocrinology, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Section of Clinical Neuropsychology, Department of Clinical, Neuro- & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Van der Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands.
Pituitary. 2021 Aug;24(4):542-554. doi: 10.1007/s11102-021-01131-w. Epub 2021 Feb 19.
The primary aim of the current study was to objectify a spectrum of persisting subjective psychological complaints in patients with hypopituitarism, at least six months after normalizing of the hormonal disturbances. Also, gender differences on these outcomes were investigated. The secondary aim was to identify illness perceptions and causal attributions within this patient group.
A total of 42 adult participants (60% females) with treated hypopituitarism once filled out a number of psychological questionnaires. The Profile of Mood States (POMS) and the Hospital Anxiety and Depression Scale (HADS) assessed mood and the Symptom Checklist-90 (SCL-90) and the Work and Social Adjustment Scale (WSAS) assessed well-being. Illness perceptions were identified using the Illness Perceptions Questionnaire-Brief Dutch Language Version (IPQ-B DLV) and causal attributions by using the Causal Attribution List (CAL). Patient outcomes were compared to reference values of healthy norm groups.
Participants scored significantly worse on the POMS depression, anger, fatigue and tension subscales, the SCL-90 psychoneuroticism, depression, inadequacy of thinking and acting and sleeping problems subscales and all subscales of the WSAS when compared to reference data. Women also scored worse on depression (HADS) and somatic symptoms (SCL-90). Compared to other illnesses, patients with hypopituitarism have more negative and realistic illness perceptions on consequences, timeline, identity and emotions. Participants attributed their complaints more to physical causes than psychological causes.
Despite normalization of hormonal disturbances, patients with hypopituitarism in general can still experience problems during daily living, such as negative mood states and a decreased psychological well-being.
本研究的主要目的是客观地描述接受治疗的垂体功能减退症患者在激素紊乱正常化至少六个月后持续存在的主观心理问题，同时调查这些结果在不同性别间的差异。本研究的次要目的是在这一患者群体中识别疾病认知和因果归因。
共 42 名成年参与者（60%为女性）接受了治疗的垂体功能减退症，他们填写了多项心理问卷。状态-特质焦虑问卷（STAI）和贝克抑郁自评问卷（BDI）评估了焦虑和抑郁，多维健康状况问卷简表（SF-36）评估了健康相关生活质量，简明症状清单 90 项（SCL-90）评估了心理健康，工作和社会适应量表（WSAS）评估了工作和社会适应。使用疾病认知问卷-简短荷兰语版本（IPQ-B DLV）识别疾病认知，使用归因清单（CAL）识别因果归因。患者的结果与健康对照组进行比较。
与健康对照组相比，参与者在 POMS 抑郁、愤怒、疲劳和紧张分量表、SCL-90 神经症、抑郁、思维和行动不足以及睡眠问题分量表以及 WSAS 的所有分量表上的得分显著更低。女性在 HADS 抑郁和 SCL-90 躯体症状上的得分也更低。与其他疾病相比，垂体功能减退症患者对疾病的后果、时间进程、身份和情绪有更消极和现实的认知。患者将他们的症状更多地归因于身体原因而不是心理原因。
尽管激素紊乱已经正常化，但垂体功能减退症患者在日常生活中仍可能会出现问题，如负面情绪状态和心理健康下降。
