Introduction: Cushing's disease is known to disturb psychosocial well-being and health-related quality of life (HRQoL) for years after treatment and normalization of cortisol levels. As the reasons for long-lasting impairments are yet unclear, we conducted a postal survey on postsurgical after-care, psychosocial impairment and coping strategies in patients after surgical treatment of CD. Methods: A set of self-assessment inventories including questionnaires on depression (Hospital Anxiety and Depression Scale, HADS), HRQoL (Short Form SF-36, Tuebingen Cushing's Disease CD-25) and coping style (Freiburg Questionnaire on Coping with Illness, FKV-LIS) was sent to all patients with CD who had been operated upon ACTH-producing pituitary adenomas at the neurosurgical departments of Erlangen, Tuebingen and Essen during the last years. They also received a self-developed questionnaire on disease duration, treatment, self-perceived disease burden and after-care. For the present analysis the complete Erlangen sample of 101 patients (21 male, 80 female) has been regarded. Results: Patients were questioned on average 6.2 years after diagnosis of CD and were of a mean age of 45.3 years. 5 patients reported elevated cortisol serum levels, 44 normal and 21 too low levels, while 31 patients did not know their current cortisol levels. Psychological HRQol was severely impaired (mental sum score SF-36 > 2 SD below mean) in 28.7% of the patients, while manifest depression (HADS) was present in 11.9% and anxiety (HADS) even in 22.8% of the investigated patients. Interestingly, maladaptive coping (FKV-LIS subscales „depressive coping“ and „minimizing importance“) correlated significantly with more self-assessed present disease burden, severity of depression and anxiety and impaired psychological HRQoL. Conclusion: Even 6 years after diagnosis patients with CD suffer from considerable impairment of psychosocial well-being. Its severity is, however, clearly influenced by the patient's way of dealing with the illness. These results are in line with studies with other patient cohorts with diseases ranging from multiple sclerosis to low back pain. Therefore, it should be considered to add psychological trainings of positive coping styles to the treatment strategy of CD.