Psychosocial impairment in patients treated for pituitary disease: a controlled study

OBJECTIVE: To verify whether patients with pituitary disorders in remission and on appropriate treatment display significant differences in psychological distress compared to healthy controls and other patients treated for nonpituitary endocrine disorders. DESIGN: A single-centred, controlled study. PATIENTS: Eighty-six outpatients cured or in remission for at least 9 months following appropriate treatment by surgery, irradiation and/or pharmacological interventions for pituitary disease were compared with 86 healthy subjects. A sample comprising 60 outpatients cured or in remission from nonpituitary endocrine disorders was also compared. MEASUREMENTS: (1) A modified version of the Structural Clinical Interview for DSM-IV; (2) a shortened version of the structured interview for the Diagnostic Criteria for Psychosomatic Research (DCPR); (3) the Psychosocial Index (PSI); and (4) the Medical Outcomes Study (MOS) short form General Health Survey (SF-20) were employed. RESULTS: Patients with pituitary disease displayed a higher prevalence of psychiatric disease (P < 0.001) compared to controls, but not when compared to nonpituitary endocrine patients. They also showed a higher prevalence of DCPR clusters compared to controls (P < 0.001), but not when compared to nonpituitary endocrine patients. At PSI and MOS (SF-20), patients with endocrine disease, whether pituitary or not, reported more psychological distress, and less well-being (P < 0.001) compared to controls. CONCLUSIONS: At follow-up after appropriate treatment, we documented a high prevalence of psychopathology in patients with pituitary disease, which was however, similar to that found in nonpituitary endocrine patients. This is consistent with an increasing body of literature that reports difficulties in obtaining full recovery in patients treated for endocrine disorders.