title: Persistent self-consciousness about facial appearance, measured with the Derriford appearance scale 59, in patients after long-term biochemical remission of acromegaly.
abstract: BACKGROUND
  Acromegaly is associated with impaired quality of life (QoL) and causes anatomical disproportions, which may contribute to the decreased QoL after successful treatment. The Derriford appearance scale 59 (DAS59) is a questionnaire measuring psychological distress and disruptions to everyday life associated with self-consciousness of appearance.
  
  
  OBJECTIVE
  Investigate the psychological distress and dysfunction related to self-consciousness about appearance and its effect on QoL in patients in long-term remission of acromegaly.
  Patients (>18 years old) treated for acromegaly at the Department of Endocrinology of the Radboud University Medical Center Nijmegen were invited to participate. A gender-, age- and body mass index matched control group was provided by the patients themselves. Participants were asked to complete the modified DAS59-, research and development 36- (RAND-36), acromegaly quality of life questionnaire (AcroQoL) and a sociodemographic questionnaire. Differences between patient- and control groups and correlations between questionnaire scores and clinical characteristics collected from medical records were analyzed.
  
  
  METHODS
  Questionnaire scores.
  
  
  RESULTS
  Of the 120 respondents, 73 agreed to participate [all cured or under biochemical control, median remission time 10.5 years (range 2.3-43.6 years)]. Of these, 34 (46.6%) reported self-consciousness about their appearance. Twenty-nine of these patients (85.3%) pointed out their face to be a prominent source of self-consciousness. Fifty-seven matched control subjects were included as well. Significant correlations were found between the scores of the DAS59 and the AcroQoL, RAND-36 and VAS in patients.
  
  
  CONCLUSIONS
  Even after long-term remission of acromegaly, a large number of patients are self-conscious about their appearance, leading to psychological distress and disruptions to everyday life and decreased QoL. Facial features were the most important source of self-consciousness. This stresses the importance of addressing self-consciousness of appearance and the need for additional support in this regard during follow-up in these patients.
authors: Division of Endocrinology (471), Department of Medicine, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, PO Box 9101, 6500 HB, Nijmegen, The Netherlands, Sean.Roerink@radboudumc.nl.
authors: S H P P
authors: SH
authors: Roerink
authors: M A E M
authors: MA
authors: Wagenmakers
authors: J F
authors: JF
authors: Wessels
authors: R B T M
authors: RB
authors: Sterenborg
authors: J W
authors: JW
authors: Smit
authors: A R M M
authors: AR
authors: Hermus
authors: R T
authors: RT
authors: Netea-Maier
mesh_terms: D000046:Academic Medical Centers; D000172:Acromegaly / Q000097:blood / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001828:Body Image; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005145:Face; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D012074:Remission Induction; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019382:Human Growth Hormone