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Abstract:
Objectives: Several studies reported decreased quality of life (QoL) and
sleep as well as increased rates of depression for patients with
pituitary adenomas. Our aim was to explore to what extent differences in
depression and sleep quality contribute to differences in QoL between
patients with pituitary adenomas and controls.
Design: A cross-sectional case-control study.
Setting: Endocrine Outpatient Unit of the Max Planck Institute of
Psychiatry, Munich, Department of Internal Medicine,
Ludwig-Maximilians-University, Munich, and the Institute of Clinical
Psychology and Psychotherapy, Technical University, Dresden.
Participants: Patients with pituitary adenomas (n = 247) and controls
(from the DETECT cohort, a large epidemiological study in primary care
patients) matched individually by age and gender (n = 757).
Measurements: Sleep quality was assessed with the Pittsburgh Sleep
Quality Index (PSQI) and QoL was measured by the generic EQ-5D and
calculated by the time trade-off- and VAS-method. Depression was
categorized as 'no depression', 'subclinical depression', and 'clinical
depression' according to the Beck Depressions Inventory for patients and
the Depression Screening Questionnaire for control subjects.
Statistical analyses: General linear and generalized, logistic mixed
models as well as proportional odds mixed models were calculated for
analyzing differences in baseline characteristics and in different
subgroups.
Results: Patients with pituitary adenomas showed decreased QoL (VAS
index: 0.73 +/- 0.19) and sleep (PSQI score: 6.75 +/- 4.17) as well as
increased rates of depression ( subclinical or clinical depression:
41.4%) compared with their matched control subjects (VAS index: 0.79 +/-
0.18, PSQI score: 5.66 +/- 4.31, subclinical or clinical depression:
25.9%). We have shown that a substantial proportion of the reduced QoL
(48% respectively 65%) was due to the incidence of depression and
reduced sleep quality.
Conclusions: These findings emphasize the importance of diagnosing
depressive symptoms and sleep disturbances in patients with pituitary
disease, with the ultimate goal to improve QoL in patients with
pituitary adenomas.
