Qualidade de vida e estados de ansiedade e depressão em pacientes com acromegalia

Abstract

Acromegaly is a disease characterized by chronic overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Acromegaly is associated with psychiatric disorders such as depression and anxiety and it can be affectedquality of life. In this study, we assessed the quality of life of these patients using the Acromegaly Quality of Life Questionnaire (AcroQoL) and the presence of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). Seventy-five individuals participated in the study, 56 patients and 19 controls. Acromegalic patients had a higher frequency of risk of depression (OR = 2.133; 95% CI = 0.546 - 8.334; P = 0.252) and anxiety (OR = 2.258; 95% CI = 0.716 - 7.124; P = 0.159), however it was not significant. Depression was associated with dyslipidemia (OR = 4.442; 95% CI 1.444 - 13.384; P = 0.039) and anxiety with the presence of headache (OR = 5.873; 95% CI 2.109 - 16.351; P = 0.002) and the clinical diagnosis of depression (OR = 7; 95% CI 2.163 - 22.649; P = 0.003). Anxiety and alcoholism were inversely associated (OR = 0.179; 95% CI 0.037 - 0.87; P = 0.035). Global AcroQoL score was 55.70 ± 23.48, with a lower score in the physical domain (51.62 ± 20.07) and higher in a personal relationship (63.84 ± 26.92). There was a positive correlation between physical activity and the physical domains and personal relationship of AcroQoL (β = -0.27, p = 0.046) (β = -0.33, p = 0.014) and with better quality of life in all domains of the AcroQoL (P <0.05). There was a negative correlation between all domains of AcroQoL and HADS, mainly between total AcroQoL and physical domain with HADS-D (p <0.001 r: -0.702) (p <0.001 r: - 0.714) which were strongly correlated. In conclusion, physical domain is the most impaired in the quality of life of the acromegalic and depression and anxiety are frequent in this population. Quality of life, anxiety and depression are associated and independent parameters of disease remission and treatment, but related to the patient's lifestyle. The state of depression seems to have greater power over the quality of life, mainly in the general and physical aspects.