Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process.
A prospective study of 48 patients with pituitary adenomas, 19 adenomas causing Cushing's disease, 18 adenomas causing acromegaly, and 11 clinically hormone-inactive adenomas (inactive adenomas), was performed to study emotional disorders occurring before and after transsphenoidal microsurgery. Factors which led to an obvious delay in the diagnostic process were identified. - The tools utilised were an interview and repeated personality assessments. The personality assessments were begun preoperatively and continued for about half a year postoperatively. The interview data, including retrospective statements regarding somatic difficulties, was analysed. - The thesis of a uniform psychopathology due to the influence of elevated hormone levels, and a lack in patients' sensitivity towards their changed appearance in acromegaly could not be confirmed. A high variability of reported emotional problems was found. The most common psychopathological signs for Cushing's disease were excitability and depression, for acromegaly fatigue/loss of energy was the most frequent complaint. Six to eight months postoperatively, a majority of patients noticed an increase of physical well-being. In acromegaly, the time span between first consultation and diagnosis averaged 6.2 years, in Cushing's disease it was 4.3 years, and in inactive adenomas it was 3.9 years. Only a small part of the delay in diagnosis, less than two years, could be attributed to the patients' hesitation to consult a physician.
Flitsch
J
J
Clinic of Neurosurgery, University Hospital Eppendorf, Hamburg, Germany. flitsch@uke.uni-hamburg.de
Spitzner
S
S
Lüdecke
D K
DK
D000172:Acromegaly / Q000503:physiopathology / Q000523:psychology; D000236:Adenoma / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery; D000328:Adult; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010555:Personality Inventory; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery