Endocrine Abstracts

Introduction: Cushing’s disease (CD) and acromegaly, despite their different specific symptoms, often present psychopathology (mainly depression and anxiety) even after hormonal normalization. However, their psychopathological profiles may be different. The aim of this study was to analyse the psychopathological profile in successfully treated Acromegaly and CD, and to compare both diseases. Current hormonal evaluation and time since endocrine control will also be analysed.

Methods: Twenty-one patients in remission of CD, twenty patients with controlled acromegaly for at least one year and 41 matched controls for age, sex and education years were included in the study. They completed SCL-90R, Beck Depression Inventory II (BDI-II), State- Trait Anxiety Inventory (STAI) and underwent endocrine evaluation.

Results: Patients with CD and acromegaly presented more psychopathology than controls in most of the areas evaluated (Depression, Anxiety, Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Hostility, Paranoid Ideation, Psychoticism, Global Severity Index, Positive Symptom Distress Index and Positive Symptoms Total P<0.05 all). No differences were found between CD patients and controls for Phobic Anxiety, or between acromegalic patients and controls for Paranoid Ideation and Phobic Anxiety. When comparing both patient groups, scores were similar for BDI-II, STAI and most of the areas of the SCL-90 questionnaire. Only for Somatization (P<0.001), Paranoid Ideation (P=0.036) and Global Severity Index (P=0.036) CS patients had higher scores, while in acromegaly scores were higher for Positive Symptoms Total (P=0.001). In CD (excluding those taking hydrocortisone), correlations were found between psychopathology and both morning cortisol (STAI-State: P=0.027, R=0.521, STAI-Trait: P=0.037, R=0.495, Depression P=0.035, R=0.513, Hostility: P=0.041, R=0.500) and 24 hour urinary free cortisol (STAI-Trait: P=0.038, R=0.521, Depression: P=0.038, R=0.539, Hostility: P=0.007, R=0.663, Psychoticism: P=0.024, R=0.578, Global Severity Index: P=0.012, R=0.629, Positive Symptoms Total: P=0.040, R=0.534). No correlations were found between psychopathology and IGF1 or GH in acromegaly. No correlations were found in normal controls between psychopathology and hormonal parameters. Psychopathology did not correlate with time since endocrine control.

Conclusions: After at least 1 year of cure, patients with CD and acromegaly score higher on psychopathology than controls. Current cortisol evaluation, despite being within normal values, correlated with psychopathology in CD, but not in controls. Despite some similarities, CD showed more somatizations, paranoid ideation and higher severity of psychopathological symptoms, while acromegalic patients reported a higher number of psychopathological symptoms.