GLOBAL PSYCHOLOGICAL ASSESSMENT WITH EVALUATION OF LIFE AND SLEEP QUALITY, SEXUAL AND COGNITIVE FUNCTION IN A LARGE NUMBER OF PATIENTS WITH ACROMEGALY: : A cross-sectional study.

Abstract

Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays limited data are available on the interplay between hormonal excess and psychological discomfort. The study aimed at investigating the psychological profile, sleep quality, sexual function, cognitive functions, and quality of life in acromegaly. in 223 acromegaly patients from five referral centres global psychological profile, sleep quality, sexual function, cognitive function, and quality of life were investigated. depression was found in 30% of patients, and anxiety in two-thirds, together with severe discomfort in body image mainly in women. Obstructive sleep apnea syndrome (OSAS)risk and sleep disorders were found in >50% of patients, and daily sleepiness in 20%. Sexual dysfunction was reported in most patients, with the most severe impairment in women. Cognitive functions were compromised in 10% of cases. Disease duration, patient age and gender were the main determinants of such psychological effects. Depression (p=0.047), somatic affective mood lowering (p=0.021), state (p<0.001) and trait (p=0.013) anxiety, and body image distortion at Body Uneasiness Test (BUT) A (p<0.001) and B (p=0.006) were significantly worsened in patients <45 years, and slightly worsen in those diagnosed <2 years before. International Index for Erectile Function (IIEF)-15 (p<0.001) and Female Sexual Function Index (FSFI) (p<0.001) scores were significantly worsened in patients >64 years and slightly worsened in those diagnosed >10 years before, particularly in presence of cardiometabolic and respiratory complications. Cognitive symptoms were slightly worsened in older patients and in those with long disease. Acromegaly is associated with a relevant impairment of psychological profile persisting despite remission and long-term medical treatment.