EPA-1338 – Psychopathology in Patients with Acromegaly

Abstract

Introduction

Acromegaly is a rare, severe, life-threatening disease, with mortality twice at that normal. It is characterized by increased and disregulated growth hormone (GH) production, usually caused by a GH-secreting pituitary tumor (somatotropinoma). Pituitary lesions are supposed to alter mood and personality.

Aims

To assess point prevalence of mental disorders in patients with acromegaly.

Methods

This is a cross-sectional cohort study of 118 patients with acromegaly (aged 21-78 years) included into the Registry of acromegaly of the Moscow Region with total population of 7 million. All patients met international diagnostic criteria for acromegaly, including laboratory measurements and brain MRI. Mental disorders were diagnosed according to ICD-10 criteria; with additional use of MINI, Hypomania Checklist and cognitive battery.

Results

In total mental disorders were found in 88/118 (74,6%) patients. 56% of all patients referred to cluster of organic mental disorders, including mild dementia, mood, anxiety, personality, asthenic and mild cognitive disorders. 4,2% had alcohol dependence, 5,1% - schizophrenia spectrum disorders. Affective disorders were diagnosed in 30%, including bipolar disorder II - 12,7%, cyclothymia - 5,1%. Neurotic, stress related and somatoform disorders were discovered in 12,7% of patients; personality disorder - in 1,7%. Mutual comorbidity among mental disorders reached 1,39.

Conclusion

Study performed with the large sample of patients with acromegaly shows a higher prevalence of psychopathology. This fact evidence that patients with acromegaly need special mental care.

The predominance of bipolar disorder with hypomania might be the result of stimulating effect of GH.

Psychotic morbidity significantly exceeds that in total population, which can be explained by dysfunction of dopaminergic pathways.