Persistent psychological distress in patients treated for endocrine disease.
BACKGROUND
The purpose of the study was to assess the frequency and characteristics of psychological distress, even after adequate treatment, in the heterogeneous population of an endocrine outpatient clinic.


METHODS
146 endocrine patients (31 males/115 females; age 39.4 +/- 12.5 years), who were cured or in remission, were studied in a university endocrine outpatient clinic. Semistructured clinical interviews to assess psychiatric (Structured Clinical Interview for DSM-IV) and psychological (Diagnostic Criteria for Psychosomatic Research, DCPR) diagnoses were employed and were supplemented by self-rated instruments (the Psychosocial Index and the Medical Outcome Study short form General Health Survey) which could provide the patients' perception of their own quality of life.


RESULTS
There were 118 patients (81%) who presented with at least 1 psychiatric (DSM-IV) or psychological (DCPR) diagnosis. The most frequent diagnostic findings were generalized anxiety disorder (29%), major depression (26%), irritable mood (46%), demoralization (34%) and persistent somatization (21%). By self-rated instruments, patients with at least 1 DSM-IV or DCPR diagnosis reported significantly more stressful life circumstances, psychological distress and an impaired quality of life compared to those who had none.


CONCLUSIONS
A high prevalence of psychological distress may be encountered in the long-term follow-up of endocrine patients. A biopsychosocial consideration of the person and his/her quality of life appears to be mandatory for improving therapeutic effectiveness in endocrine disorders.
Sonino
Nicoletta
N
Department of Statistical Sciences, University of Padova, Padova, Italy. nicoletta.sonino@unipd.it
Navarrini
Cecilia
C
Ruini
Chiara
C
Ottolini
Fedra
F
Paoletta
Agostino
A
Fallo
Francesco
F
Boscaro
Marco
M
Fava
Giovanni A
GA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety; D015331:Cohort Studies; D004700:Endocrine System Diseases / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013315:Stress, Psychological; D016896:Treatment Outcome