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Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life

Introduction: Remission criteria of acromegaly are based on biochemical variables, i.e., normalization of increased hormone levels. However, the established reduction in Quality of Life (QoL) is suggested to be independent of biochemical control. The aim of this study was to test which aspects predi...

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Autores principales: Geraedts, Victor Jacobus, Dimopoulou, Christina, Auer, Matthias, Schopohl, Jochen, Stalla, Günter Karl, Sievers, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285111/
https://www.ncbi.nlm.nih.gov/pubmed/25610427
http://dx.doi.org/10.3389/fendo.2014.00229
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author Geraedts, Victor Jacobus
Dimopoulou, Christina
Auer, Matthias
Schopohl, Jochen
Stalla, Günter Karl
Sievers, Caroline
author_facet Geraedts, Victor Jacobus
Dimopoulou, Christina
Auer, Matthias
Schopohl, Jochen
Stalla, Günter Karl
Sievers, Caroline
author_sort Geraedts, Victor Jacobus
collection PubMed
description Introduction: Remission criteria of acromegaly are based on biochemical variables, i.e., normalization of increased hormone levels. However, the established reduction in Quality of Life (QoL) is suggested to be independent of biochemical control. The aim of this study was to test which aspects predict QoL best in acromegaly. Methods/design: This is a prospective cohort study in 80 acromegalic patients, with a cross-sectional and longitudinal part. The main outcome measure was health-related QoL, measured by a generic and a disease-specific questionnaire (the SF-36 and AcroQoL). Main predictors were age, gender, biochemical control, disease characteristics, treatment modalities, and psychopathology. Results: Our cohort of 80 acromegalics had a mean age 54.7 ± 12.3 years with an average disease duration of 10.8 ± 10.0 years. Ratio macro-/microadenoma was 54/26. In adjusted mixed method models, we found that psychopathology significantly predicts QoL in acromegaly (in models including the variables age, gender, disease duration, tumor size, basal hormone levels, relevant treatment modalities, and relevant comorbidities), with a higher degree of psychopathology indicating a lower QoL (depression vs. AcroQoL: B = −1.175, p < 0.001, depression vs. SF-36: B = −1.648, p < 0.001, anxiety vs. AcroQoL: B = −0.399, p < 0.001, anxiety vs. SF-36: B = −0.661, p < 0.001). The explained variances demonstrate superiority of psychopathology over biochemical control and other variables in predicting QoL in our models. Discussion: Superiority of psychopathology over biochemical control calls for a more extensive approach regarding diagnosing depression and anxiety in pituitary adenomas to improve QoL. Depressive symptoms and anxiety are modifiable factors that might provide valuable targets for possible future treatment interventions.
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spelling pubmed-42851112015-01-21 Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life Geraedts, Victor Jacobus Dimopoulou, Christina Auer, Matthias Schopohl, Jochen Stalla, Günter Karl Sievers, Caroline Front Endocrinol (Lausanne) Endocrinology Introduction: Remission criteria of acromegaly are based on biochemical variables, i.e., normalization of increased hormone levels. However, the established reduction in Quality of Life (QoL) is suggested to be independent of biochemical control. The aim of this study was to test which aspects predict QoL best in acromegaly. Methods/design: This is a prospective cohort study in 80 acromegalic patients, with a cross-sectional and longitudinal part. The main outcome measure was health-related QoL, measured by a generic and a disease-specific questionnaire (the SF-36 and AcroQoL). Main predictors were age, gender, biochemical control, disease characteristics, treatment modalities, and psychopathology. Results: Our cohort of 80 acromegalics had a mean age 54.7 ± 12.3 years with an average disease duration of 10.8 ± 10.0 years. Ratio macro-/microadenoma was 54/26. In adjusted mixed method models, we found that psychopathology significantly predicts QoL in acromegaly (in models including the variables age, gender, disease duration, tumor size, basal hormone levels, relevant treatment modalities, and relevant comorbidities), with a higher degree of psychopathology indicating a lower QoL (depression vs. AcroQoL: B = −1.175, p < 0.001, depression vs. SF-36: B = −1.648, p < 0.001, anxiety vs. AcroQoL: B = −0.399, p < 0.001, anxiety vs. SF-36: B = −0.661, p < 0.001). The explained variances demonstrate superiority of psychopathology over biochemical control and other variables in predicting QoL in our models. Discussion: Superiority of psychopathology over biochemical control calls for a more extensive approach regarding diagnosing depression and anxiety in pituitary adenomas to improve QoL. Depressive symptoms and anxiety are modifiable factors that might provide valuable targets for possible future treatment interventions. Frontiers Media S.A. 2015-01-06 /pmc/articles/PMC4285111/ /pubmed/25610427 http://dx.doi.org/10.3389/fendo.2014.00229 Text en Copyright © 2015 Geraedts, Dimopoulou, Auer, Schopohl, Stalla and Sievers. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Geraedts, Victor Jacobus
Dimopoulou, Christina
Auer, Matthias
Schopohl, Jochen
Stalla, Günter Karl
Sievers, Caroline
Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life
title Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life
title_full Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life
title_fullStr Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life
title_full_unstemmed Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life
title_short Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life
title_sort health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285111/
https://www.ncbi.nlm.nih.gov/pubmed/25610427
http://dx.doi.org/10.3389/fendo.2014.00229
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