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Health-related Quality of Life in Patients After Treatment of Cushing's Disease.
Exp Clin Endocrinol Diabetes 2016; 124(3):187-91EC

Abstract

BACKGROUND

Patients suffering from Cushing's disease are known to be restricted due to a wide range of symptoms. Despite biochemical cure, symptoms might last life-long. These include - among well-known somatic symptoms - several neuropsychiatric symptoms that cannot be as easily tested, but lead to a serious negative impact on quality of life. We aimed to evaluate what factors diminish the self-perceived quality of life the most using 3 questionnaires visualizing those impairments. Furthermore we investigated whether there would be differences in quality of life between patients still being affected by the disease and those that are already in remission.

PATIENTS AND METHODS

We reviewed patient charts treated between April 2008 and June 2012 for Cushing's disease and sent 3 questionnaires to the patients for evaluation. For this purpose we used the SF-36, the BDI and the Tuebingen CD-25. 54 patients complied with our request and returned the completed questionnaires. The average time after surgery was 36 months.

RESULTS

In all 8 dimensions of the SF-36 significant differences between the patient collective and the expected age- and gender-specific scores could be observed and thus a detectable impairment in quality of life. The BDI revealed that every other patient suffering from Cushing's disease presented depressive symptoms, partially with clinical relevance. In all 6 dimensions of the Tuebingen CD-25 there were notable restrictions in patients. Those restrictions particularly concerned bodily restrictions and cognitive performance. The self-perceived quality of life of active patients was - although not statistically significant - in almost all measured fields worse than the test results of patients in remission after TSS.

CONCLUSION

Former and active Cushing's disease patients suffer from a wide range of neuropsychiatric symptoms. Those symptoms might dominate the clinical picture and lead to a serious impairment in quality of life as well as extend periods of suffering and might persist even years after being found healthy. Therefore it is important to evaluate quality of life as an independent factor in every patient being affected by Cushing's disease and to include a holistic view in their therapy. Concomitant therapeutic measures should be accessible at any time for Cushing's disease patients as the normalization of pathologically increased laboratory values doesn't obligatory lead to an improvement of the patients subjectively felt well-being.

Authors+Show Affiliations

Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.Department of Medical Biometry and Epidemiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany.Department for Endocrinology and Diabetology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.ENDOC Center for Endocrine Tumors, Hamburg, Germany.Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27008635

Citation

Nader, S, et al. "Health-related Quality of Life in Patients After Treatment of Cushing's Disease." Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, vol. 124, no. 3, 2016, pp. 187-91.
Nader S, Burkhardt T, Vettorazzi E, et al. Health-related Quality of Life in Patients After Treatment of Cushing's Disease. Exp Clin Endocrinol Diabetes. 2016;124(3):187-91.
Nader, S., Burkhardt, T., Vettorazzi, E., Milian, M., Aberle, J., Petersenn, S., & Flitsch, J. (2016). Health-related Quality of Life in Patients After Treatment of Cushing's Disease. Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, 124(3), pp. 187-91. doi:10.1055/s-0035-1569340.
Nader S, et al. Health-related Quality of Life in Patients After Treatment of Cushing's Disease. Exp Clin Endocrinol Diabetes. 2016;124(3):187-91. PubMed PMID: 27008635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health-related Quality of Life in Patients After Treatment of Cushing's Disease. AU - Nader,S, AU - Burkhardt,T, AU - Vettorazzi,E, AU - Milian,M, AU - Aberle,J, AU - Petersenn,S, AU - Flitsch,J, Y1 - 2016/03/23/ PY - 2016/3/24/entrez PY - 2016/3/24/pubmed PY - 2016/12/15/medline SP - 187 EP - 91 JF - Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association JO - Exp. Clin. Endocrinol. Diabetes VL - 124 IS - 3 N2 - BACKGROUND: Patients suffering from Cushing's disease are known to be restricted due to a wide range of symptoms. Despite biochemical cure, symptoms might last life-long. These include - among well-known somatic symptoms - several neuropsychiatric symptoms that cannot be as easily tested, but lead to a serious negative impact on quality of life. We aimed to evaluate what factors diminish the self-perceived quality of life the most using 3 questionnaires visualizing those impairments. Furthermore we investigated whether there would be differences in quality of life between patients still being affected by the disease and those that are already in remission. PATIENTS AND METHODS: We reviewed patient charts treated between April 2008 and June 2012 for Cushing's disease and sent 3 questionnaires to the patients for evaluation. For this purpose we used the SF-36, the BDI and the Tuebingen CD-25. 54 patients complied with our request and returned the completed questionnaires. The average time after surgery was 36 months. RESULTS: In all 8 dimensions of the SF-36 significant differences between the patient collective and the expected age- and gender-specific scores could be observed and thus a detectable impairment in quality of life. The BDI revealed that every other patient suffering from Cushing's disease presented depressive symptoms, partially with clinical relevance. In all 6 dimensions of the Tuebingen CD-25 there were notable restrictions in patients. Those restrictions particularly concerned bodily restrictions and cognitive performance. The self-perceived quality of life of active patients was - although not statistically significant - in almost all measured fields worse than the test results of patients in remission after TSS. CONCLUSION: Former and active Cushing's disease patients suffer from a wide range of neuropsychiatric symptoms. Those symptoms might dominate the clinical picture and lead to a serious impairment in quality of life as well as extend periods of suffering and might persist even years after being found healthy. Therefore it is important to evaluate quality of life as an independent factor in every patient being affected by Cushing's disease and to include a holistic view in their therapy. Concomitant therapeutic measures should be accessible at any time for Cushing's disease patients as the normalization of pathologically increased laboratory values doesn't obligatory lead to an improvement of the patients subjectively felt well-being. SN - 1439-3646 UR - https://www.unboundmedicine.com/medline/citation/27008635/Health_related_Quality_of_Life_in_Patients_After_Treatment_of_Cushing's_Disease_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0035-1569340 DB - PRIME DP - Unbound Medicine ER -