Impaired psychometric testing in polyglandular autoimmunity

Abstract

Patients with the autoimmune polyglandular syndrome (APS) could be exposed to many limitations in daily life owing to their illness. To quantify the degree of physical and emotional distress, the psychometric profile of these patients was evaluated prospectively. After a complete endocrine investigation, three international validated self-assessment questionnaires were applied in 75 patients with APS: the health-related quality of life Short-Form 36 (SF-36), the Giessen Complaint List (GBB-24) and the Hospital Anxiety and Depression Scale (HADS). Average duration of APS was 7.7 years. The most frequent disease combination was type 1 diabetes and autoimmune thyroid disease (n=47, 62.6%). Every scale of the SF-36, GBB-24, and the HADS anxiety score demonstrated markedly impaired physical and emotional well-being, foremost in female subjects (P<0.001). Compared to a German reference cohort, all subscales of the SF-36 were decreased (P<0.001). Sex- and age-matched z-scores were significantly lower for physical functioning (-1.1; reference population z=0), physical role limitations (-0.8), bodily pain (-0.7), general health perception (-1.2), vitality (-0.8), social functioning (-0.8), emotional role limitations (-1.1) and mental health (-0.5). Also, the global score of discomfort was increased in comparison with the reference population (27.27 vs 13.93, P<0.001). Generalized anxiety (25%, P<0.001) and depression episode (18.1%, P<0.001) were prevalent in APS. Neither time interval between two endocrine diseases, duration of APS, age, nor autoantibody positivity influenced psychometric testing results. Patients with APS have a severely impaired psychometric profile. Treatment modalities that would improve their well-being are warranted.