Life events and quality of life in patients of Cushing's disease

Abstract

Background: Cushing's disease (CD) is a rare endocrine disorder associated with increased serum levels of cortisol secreted due to an underlying tumour in pituitary. Stressful life events are known to aggravate CD and affect coping with the illness. Quality of life (QoL) may also be impaired due to physical changes, limitations in activity and emotional problems despite treatment of CD. Hence, we undertook this research to study the life events and QoL in patients of CD. Methods: Thirty-five patients of CD were enrolled from the endocrine outpatient department after written informed consent and institutional ethics approval. A pro forma for demographic variables and details of CD was administered with the Holmes and Rahe stressful life events scale Social Readjustment Rating Scale (SRRS) and short-form 36 (SF-36) health survey for general QoL and well-being. Results: Twenty-nine (82.5%) patients had low scores (<150) on SRRS 5 (14.28%) patients had scores in the medium range, whereas only 1 (2.86%) patient had a higher score. Thus, life events were not significant to aggravate the disease in our sample. A poor QoL was reflected in all 35 (100%) patients indicating severely impaired QoL on both mental and physical components. All the subdomains of SF-36, namely physical functioning, role limitation due to physical health and emotional health, energy/fatigue, emotional well-being, social functioning, pain and general health were affected. Conclusions: Life events experienced were not significant to worsen the underlying illness, but an impaired QoL in all spheres of functioning was evident. Liaison with the endocrinologist would also work towards improving the issues of body image disturbances and self-esteem for better prognosis for the patient.