title: Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing's syndrome.
abstract: OBJECTIVE
  Illness perceptions pertain to the pattern of beliefs patients develop about their illness. Illness perceptions are determinants of quality of life (QoL). Factors contributing to persisting impaired QoL after Cushing's syndrome (CS) remain largely unknown. Therefore, the objective of this study was to explore illness perceptions, as potentially modifiable psychological factors, in relation to QoL in patients with long-term remission of CS.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  We included patients with long-term remission of CS (n=52). Illness perceptions were evaluated using the Illness Perception Questionnaire (IPQ)-Revised, and QoL was measured using the physical symptom checklist, EuroQoL-5D (EQ-5D), and the CushingQoL. Reference data were derived from recent studies and included patients with vestibular schwannoma (n=80), acute (n=35) or chronic (n=63) pain, and chronic obstructive pulmonary disease (COPD; n=171).
  
  
  RESULTS
  Illness perceptions showed a strong correlation with QoL. Patients with CS scored distinctively more negative on the IPQ compared with patients with vestibular schwannoma and patients with acute pain, and also reported more illness-related complaints (all P<0.01). There were also some differences in illness perceptions between patients with CS and patients with chronic pain and patients with COPD, but there was no distinct pattern.
  
  
  CONCLUSIONS
  Patients after long-term remission of CS report more negative illness perceptions compared with patients with other acute or chronic conditions. Further research is needed to assess whether QoL in CS can be improved by addressing these illness perceptions, for example, by a self-management intervention program.
authors.affiliation: Department of Endocrinology and Metabolism, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. j.tiemensma@lumc.nl
authors.forename: Jitske
authors.initials: J
authors.lastname: Tiemensma
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Kaptein
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D002908:Chronic Disease; D003480:Cushing Syndrome / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D004522:Educational Status; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007018:Hypopituitarism / Q000209:etiology / Q000523:psychology; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009464:Neuroma, Acoustic / Q000523:psychology; D010146:Pain / Q000209:etiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology; D011788:Quality of Life; D012649:Self Concept; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D006854:Hydrocortisone