Endocrine Abstracts

Aim: To determine the prevalence of impulse control disorder (ICD) in patients with Cushing’s disease (CD) treated with cabergoline (CBG) compared to CBG-naive patients with CD.

Methods: We performed a cross-sectional study in patients with CD followed at 5 referral centers based in Istanbul. Eligible patients with CD were those with current CBG treatment for ≥ 3 months. Eligible controls were CBG-naive patients with CD that were matched for age and sex to CBG-treated patients. We administered Beck Depression Inventory, Beck Anxiety Inventory, and Symptom Checklist-90-Revised questionnaire to obtain a general measure of psychological distress. To evaluate impulsivity, both self-administered neuropsychological tests (Barratt Impulsiveness Scale, revised version of Minnesota Impulsive Disorders Interview, and Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale) and computerized behavioral tasks (Go/No-Go task, Iowa Gambling task, and Short Penn Continuous Performance Test) were used. All individuals underwent a detailed psychiatric assessment and the ultimate diagnosis of ICD(s), when present, was confirmed by an experienced psychiatrist. The measures of impulsivity and frequency of ICD(s) were compared between groups.

Results: A total of 34 CBG-treated patients with CD and 34 CBG-naive patients with CD were included. The mean age was 45.5 ± 11.6 in CBG-treated patients and 46.1 ± 13.5 in CBG-naive patients (P=0.731). In each group, 30 patients were female (P=1.0). The groups were similar in income, educational level, frequency of smokers, alcohol consumption, size of pituitary adenoma on last imaging study, frequency of hypogonadism and any psychiatric disorder. In CBG user group, the median duration of CBG use was 12 [IQR] 6-26.3 months. The median weekly CBG dose was 2 [IQR] 1-3.5 mg and cumulative dose was 61 [IQR] 30.6-146.4 mg. CBG-treated and CBG-naive patients showed no significant difference in measures of psychological distress and impulsivity. The most common psychiatric disorder in both groups was depression (35.3% vs. 29.2%, P=0.796). The frequency of any ICD was 8.8% (n=3) in CBG users and 5.9% (n=2) in non-users (P=1.0). In CBG-treated group, one patient was diagnosed with compulsive gambling (2.9%), one patient was diagnosed with compulsive shopping (2.9%), and another patient was diagnosed with both compulsive shopping and hobbysm (2.9%). In CBG-naive group, one patient with CD had compulsive gambling (2.9%) and one patient with CD had compulsive punding, eating, and hobbysm (2.9%).

Conclusions: Risk of ICDs may not be increased in CBG-treated patients with CD.