ICEECE2012 Poster Presentations Adrenal cortex (113 abstracts)
Anxiety and depressive symptoms in patients with primary aldosteronism in a longitudinal study
H. Künzel 1 , K. Apostolopoulou 1 , A. Pallauf 1 , G. Hanslik 2 , B. Volker 1 , F. Evelyn 1 , M. Bidlingmaier 1 , E. Stephan 1 , M. Quinckler 2 , F. Beuschlein 1 & M. Reincke 1
1LMU Munich, Munich, Germany; 2Charite Berlin, Berlin, Germany.
Context: Recent studies showed a high prevalence of anxiety and depressive symptoms in patients with primary hyperaldosteronism (PA). A cross-sectional analysis suggested only minor improvement following adrenalectomy (ADX) and mineralocorticoidreceptor antagonist (MRA) therapy.
Objective: Our aim was to determine the course of anxiety and depression in untreated patients.
Design: We investigated 15 patients with PA at time of diagnosis and 1 year after initiation of specific treatment (ADX: n=10; MRA: n=5). Blood pressure, aldosterone and renin were recorded in all patients.
Main outcome measures We used GAD-7 and PHQD questionnaires to assess anxiety and depression.
Results: At time of diagnosis patients showed significantly higher mean values for GAD-7 (6.3±4.5) and PHQ-D (7.5±6.6) compared to the general population. One year later mean systolic blood pressure (153±20 vs 128±13), serum potassium (3.6±0.7 vs 4.4±0.3) and the aldosterone to renin ratio in ADX patients (64±63 vs 12±15) had significantly improved. In parallel, psychopathology improved to some degree (GAD-7: 4.7±3.8; PHQ-D 4.4±5.2), but still 11 of 15 patients had scores outside the normal range. Gender differences were found. For depression females showed before (b) and after (a) treatment higher scores by trend (b: f 10.71±6.15; m 4.63±5.87 P=0.72; a: f 7.0±5.94; m 2.13±3.44 P=0.07). For anxiety females and males showed a significant difference after initiation of treatment. (b: f 7.33±3.14; m 5.5±5.63 p=0.46; a: f 7.83±3.54; m 2.63±2.2 P=0.004).
Conclusion: Patients with PA show a rapid and sustained improvement following intervention for their somatic parameters, but depressive symptoms and anxiety appear to improve more slowly especially in women.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.
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