Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
UNESCO Chair for Health Education and Sustainable Development, 'Federico II' University, Naples, Italy.
Eur J Endocrinol. 2022 Dec 13;187(6):823-845. doi: 10.1530/EJE-22-0263. Print 2022 Dec 1.
Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays, limited data are available on the interplay between hormonal excess and psychological discomfort. The study aimed at investigating the psychological profile, sleep quality, sexual function, cognitive functions, and quality of life in patients with acromegaly.
In 223 acromegaly patients from 5 referral centres, global psychological profile, sleep quality, sexual function, cognitive function, and quality of life were investigated.
Depression was found in ~30% of patients, and anxiety in two-thirds, together with severe discomfort in body image mainly in women. Obstructive sleep apnoea syndrome risk and sleep disorders were found in >50% of patients and daily sleepiness in ~20%. Sexual dysfunction was reported in most of the patients, with the most severe impairment in women. Cognitive functions were compromised in ~10% of cases. Disease duration and patient's age and gender were the main determinants of these psychopathological conditions. Depression (P = 0.047), somatic-affective mood lowering (P = 0.021), state (P < 0.001) and trait (P = 0.013) anxiety, and body image distortion in body uneasiness test A (P < 0.001) and B (P = 0.006) were significantly worsened in patients <45 years and slightly worsened in those with disease duration less than 2 years. Male (P < 0.001) and female (P < 0.001) sexual function scores were significantly worsened in patients aged >64 years and slightly worsened in those with disease duration for more than 10 years, particularly in presence of cardiometabolic and respiratory complications. Cognitive symptoms were slightly worsened in older patients and in those with long disease duration.
Acromegaly is associated with a relevant impairment of psychological profile persisting despite remission and long-term medical treatment.
肢端肥大症与躯体畸形有关，这些畸形会影响患者的幸福感和生活质量。目前，关于激素过度分泌与心理不适之间相互作用的资料有限。本研究旨在调查肢端肥大症患者的心理状况、睡眠质量、性功能、认知功能和生活质量。
在 5 家转诊中心的 223 例肢端肥大症患者中，调查了他们的整体心理状况、睡眠质量、性功能、认知功能和生活质量。
约 30%的患者存在抑郁，三分之二的患者存在焦虑，同时女性患者对自身形象的不适更为严重。超过 50%的患者存在阻塞性睡眠呼吸暂停综合征风险和睡眠障碍，约 20%的患者存在日间嗜睡。大多数患者存在性功能障碍，女性患者的性功能障碍最为严重。约 10%的患者认知功能受损。疾病持续时间、患者年龄和性别是这些精神病理状况的主要决定因素。与年龄较大和患病时间较长的患者相比，年龄<45 岁和患病时间<2 年的患者抑郁（P = 0.047）、躯体情感低落（P = 0.021）、状态（P<0.001）和特质（P = 0.013）焦虑以及身体不适测试 A（P<0.001）和 B（P = 0.006）中的身体形象扭曲更为严重。年龄>64 岁的男性（P<0.001）和女性（P<0.001）性功能评分明显恶化，患病时间>10 年的患者评分略有恶化，尤其是存在心血管代谢和呼吸系统并发症的患者。年龄较大的患者和患病时间较长的患者认知症状略有恶化。
尽管缓解和长期药物治疗后，肢端肥大症仍会导致明显的心理状况受损。
