Peace K A, Orme S M, Sebastian J P, Thompson A R, Barnes S, Ellis A, Belchetz P E
Department of Endocrinology, General Infirmary at Leeds, UK.
Clin Endocrinol (Oxf). 1997 Apr;46(4):445-50. doi: 10.1046/j.1365-2265.1997.1600971.x.
Studies of mood in hypopituitary adults have yielded inconsistent results. This investigation was carried out to investigate whether treatment characteristics may be responsible for the inconsistent results.
We compared three groups of patients with a group of matched healthy controls on self-report measures of mood and social adjustment (Beck depression inventory, State-trait anxiety inventory, Social adjustment scale (modified)) and a measure of quality of life (Nottingham health profile, NHP).
The patient groups were those treated with transfrontal surgery (n = 23), transsphenoidal surgery (n = 23) or medication only (n = 23). In addition, a close informant of each subject was asked to complete a social adjustment measure about the subject's level of adjustment.
On the self-report mood and social adjustment measures and the emotion sub-scale of the NHP, the transsphenoidal and medication patient groups rated themselves as being more depressed, anxious and having poorer social adjustment than the transfrontal or control groups. The close informants, however, rated all three patient groups as having poorer social adjustment than the controls. Patients treated with surgery and without radiotherapy reported fewer symptoms of depression than those treated with radiotherapy. Realistic self-appraisal of social adjustment in surgical patients was found only in those treated with transsphenoidal surgery without radiotherapy.
Patients treated for pituitary tumour, excepting those treated with transfrontal surgery and to a lesser extent those treated with radiotherapy, suffer from mild mood disturbance and self-perceived decreased social adjustment. All patient groups are seen by others as having decreased social adjustment, raising the possibility that the transfrontal patients and possibly those who have had radiotherapy, lack insight. This may explain some of the discrepancies in the previous literature and needs to be taken into account when using self-report measures with these patients.
对垂体功能减退成年患者情绪的研究结果并不一致。开展本调查以探究治疗特征是否可能是导致结果不一致的原因。
我们将三组患者与一组匹配的健康对照者在情绪和社会适应的自我报告测量指标（贝克抑郁量表、状态-特质焦虑量表、改良版社会适应量表）以及生活质量测量指标（诺丁汉健康量表，NHP）上进行了比较。
患者组分别为接受经额手术治疗的患者（n = 23）、经蝶窦手术治疗的患者（n = 23）或仅接受药物治疗的患者（n = 23）。此外，要求每位受试者的一位密切知情者完成一项关于该受试者适应水平的社会适应测量。
在自我报告的情绪和社会适应测量指标以及NHP的情绪子量表上，经蝶窦手术组和药物治疗组患者自我评定为比经额手术组或对照组患者更抑郁、焦虑，且社会适应更差。然而，密切知情者评定所有三组患者的社会适应均比对照组差。接受手术且未接受放疗的患者报告的抑郁症状比接受放疗的患者少。仅在接受未放疗的经蝶窦手术治疗的患者中发现了对手术患者社会适应的现实自我评估。
接受垂体肿瘤治疗的患者，除经额手术治疗的患者以及在较小程度上接受放疗的患者外，均存在轻度情绪障碍和自我感知的社会适应能力下降。其他人认为所有患者组的社会适应能力均下降，这增加了经额手术患者以及可能接受过放疗的患者缺乏洞察力的可能性。这可能解释了既往文献中的一些差异，在对这些患者使用自我报告测量指标时需要考虑到这一点。
