title: Quality of life in Cushing's syndrome.
abstract: BACKGROUND
  Cushing syndrome (CS) of any etiology (adrenal, pituitary or ectopic) impacts negatively on health-related quality of life (QoL), especially in active hypercortisolism but also after endocrine cure. Both generic questionnaires like the short-form 36 health survey -SF-36- and the derived SF-12, or the Hospital Anxiety and Depression Scale (HADS), and disease-specific measures like the CushingQoL and the Tuebingen CD-25 questionnaires have provided information on the impact of CS on patients perceived health.
  
  
  METHODS
  Studies published since January 2013 until November 2014 on QoL in patients with CS were identified, reviewed and summarized.
  
  
  CONCLUSIONS
  Treatment of CS improves patients perceived QoL, but it often takes many months and often never normalizes. In parallel to persistent QoL impairment in cured CS, brain and cerebellar volume are reduced. Depression, anxiety and cognitive dysfunction are common. Pediatric patients with CS also present worse QoL than normal children, as well as additional issues like delayed growth and pubertal development, next to abnormal body composition, psychological and cognitive maturation. Fluoxetine has been suggested as a neuroprotectant and antidepressant for patients with CS, although no prospective studies are yet available. The CushingQoL questionnaire has been mapped to well-validated instruments like SF-36 or EQ-5D, and therefore may be used in cost-utility and other health economy studies.
authors: Endocrinology/Medicine Departments, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII, Hospital Sant Pau, Barcelona, Spain.
authors: Alicia
authors: A
authors: Santos
authors: Iris
authors: I
authors: Crespo
authors: Anna
authors: A
authors: Aulinas
authors: Eugenia
authors: E
authors: Resmini
authors: Elena
authors: E
authors: Valassi
authors: Susan M
authors: SM
authors: Webb
mesh_terms: D049913:ACTH-Secreting Pituitary Adenoma / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D017281:Cost of Illness; D006801:Humans; D047748:Pituitary ACTH Hypersecretion / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011594:Psychometrics; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
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