Endocrine Abstracts

Clinic based studies have shown that patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulphate in addition to glucocorticoids and mineralocorticoids. DHEA is thought to have beneficial effects on energy level and mood, independent of circulating testosterone levels. Thus there may be a direct link between DHEA deficiency and psychological morbidity in Addison's disease.

We measured well-being in 16 patients with Addison's disease (aged between 35 and 79) and a control group of similar age and gender distribution of 15 hospital attendees with type 2 diabetes mellitus (well-controlled and free of major organ complications). Subjects completed the General Health Questionnaire (GHQ), Hospital Anxiety and Depression Scale (HADS), WHO quality of life assessment (WHOQOL-BREF) and the Holmes-Rahe life event scale. DHEA-S was measured by enzyme labelled immunoassay (DPC Immulite 2000).

DHEA-S was low in Addison's patients (men 1.7±0.2 (mean±se) micromol/l (normal range 2.1-10.8), women 1.3±0.3nmol/l (1.0-11.5)). DHEA-S levels were normal in controls. Testosterone levels were similar in both groups studied.

There were no differences in emotional well being and quality of life between patients with Addisons disease and Type 2 Diabetes Mellitus as measured by GHQ (Addisons 22.4±2.6, Diabetes 19.6±2.7), HADS Anxiety (Addisons 7.1±1.9, Diabetes 6.4±0.6), HADS Depression (Addisons 5.4±0.9, Diabetes 4.5±1.4) and WHOQOL-BREF. There were no gender differences in affective symptomatology within the Addisons cohort. Life event scores were above average in both groups (Addisons 195±39.6, Diabetes 131±43.8), pNS (for difference between groups) as was GHQ total score.

Both groups scored highly on the GHQ, indicative of poorer health perceptions than the general population. This could be due to the chronicity of both disorders. Importantly we have not identified any specific effects of DHEA deficiency on mood / quality of life.