Increased Psychopathology and Maladaptive Personality Traits, But Normal Cognitive Functioning, In Patients after Long-Term Cure of Acromegaly

• Published in: The journal of clinical endocrinology and metabolism 2010-12, Vol.95 (12), p.E392-E402
• Main Authors: Tiemensma, Jitske, Biermasz, Nienke R, van der Mast, Roos C, Wassenaar, Moniek J. E, Middelkoop, Huub A. M, Pereira, Alberto M, Romijn, Johannes A
• Format: Article
• Language: English
• Subjects: Acromegaly - psychology; Acromegaly - radiotherapy; Acromegaly - surgery; Acromegaly - therapy; Affect; Anxiety - psychology; Cross-Sectional Studies; Depression - psychology; Educational Status; Female; Humans; Interviews as Topic; Long-Term Care - psychology; Male; Mental Disorders - epidemiology; Mental Disorders - etiology; Middle Aged; Patient Selection; Personality Disorders - epidemiology; Personality Disorders - etiology; Pituitary Neoplasms - psychology; Reference Values
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2010-1253

Objective: Active acromegaly is associated with psychopathology, personality changes, and cognitive dysfunction. It is unknown whether, and to what extent, these effects are present after long-term cure of acromegaly. Aim: The aim of the study was to assess psychopathology, personality traits, and cognitive function in patients after long-term cure of acromegaly. Design: This was a cross-sectional study. Patients and Methods: We studied 68 patients after long-term cure (13 ± 1 yr) of acromegaly and 68 matched controls. We compared these data with 60 patients treated for nonfunctioning pituitary macroadenomas (NFMAs) and 60 matched controls. Psychopathology was assessed using the Apathy Scale, Irritability Scale, Hospital Anxiety and Depression Scale, and Mood and Anxiety Symptoms Questionnaire short-form, and personality was assessed by the Dimensional Assessment of Personality Pathology short-form (DAPPs). Cognitive function was assessed by 11 tests. Results: Compared with matched controls, patients cured from acromegaly scored significantly worse on virtually all psychopathology questionnaires and on several subscales of the DAPPs. Compared with NFMA patients, patients cured from acromegaly scored worse on negative affect (P = 0.050) and somatic arousal (P = 0.009) and seven of 18 subscales of the DAPPs (P < 0.05). Cognitive function in patients cured from acromegaly did not differ from matched controls or patients treated for NFMA. Conclusion: Patients with long-term cure of acromegaly show a higher prevalence of psychopathology and maladaptive personality traits but not cognitive dysfunction, compared with matched controls and patients treated for NFMA. These results suggest irreversible effects of previous GH excess, rather than effects of pituitary adenomas per se and/or their treatment, on the central nervous system. Patients with long-term cure of acromegaly show increased prevalence of psychopathology and maladaptive personality traits.