Evaluation of Depression, Anxiety, Body Perception and Sexual Functions in Patients Diagnosed With Acromegaly

Öz

Acromegaly is a chronic disease that can cause somatic disfigurement and hormonal changes. The aim of this study was to examine depression and anxiety levels, body image and sexual dysfunctions in patients with acromegaly and to compare them with those of controls. 52 patients with acromegaly who were being followed up at the Endocrinology Outpatient Clinic and 51 non-acromegalic individuals were included. The participants were evaluated cross-sectionally once and evaluated with the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Body Image Scale (BIS) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The GRISS total, infrequency, dissatisfaction, impotence and premature ejaculation subdimension scores of the acromegaly patients were found to be significantly higher than those of the controls. Sexual dysfunctions were associated with older age, female sex, unemployment, menopausal status, and the presence of concomitant diabetes mellitus. No meaningful differences were detected in depression or anxiety scores between patients and controls. Body image was significantly more impaired in patients with acromegaly and was associated with higher depression and anxiety scores. There was no difference between scale scores according to disease activity. Although inverse correlations were observed between GRISS total scores and IGF-1 and free T4 levels in univariate analyses, IGF-1 was not independently associated with sexual dysfunction after adjustment for relevant clinical covariates. In conclusion, considering that patients with acromegaly are a risky group in terms of mental disorders and sexual dysfunctions, we recommend that patients should be routinely questioned in terms of psychopathology and sexual functions during their follow-up.

Anahtar Kelimeler

• acromegaly
• depression
• anxiety
• body image
• sexual dysfunction

Akromegali Hastalarında Depresyon, Anksiyete, Beden Algısı ve Cinsel İşlevlerin Değerlendirilmesi

Öz

Akromegali, somatik şekil bozukluklarına ve hormonal değişikliklere yol açabilen kronik bir hastalıktır. Bu çalışmanın amacı, akromegali tanılı hastalarda depresyon ve anksiyete düzeylerini, beden imajını ve cinsel işlev bozukluklarını incelemek ve kontrol grubuyla karşılaştırmaktır. Endokrinoloji Polikliniği’nde takip edilmekte olan 52 akromegali hastası ve 51 sağlıklı birey çalışmaya dâhil edilmiştir. Katılımcılar kesitsel olarak bir kez değerlendirilmiş; Beck Depresyon Ölçeği (BDÖ), Beck Anksiyete Ölçeği (BAÖ), Beden İmajı Ölçeği (BİÖ) ve Golombok-Rust Cinsel Doyum Ölçeği (GRCDÖ) ile ölçümler yapılmıştır. Akromegali hastalarının GRCDÖ toplam, ilişki sıklığı, tatminsizlik, empotans ve erken boşalma alt ölçek puanları kontrol grubuna göre anlamlı derecede yüksek bulunmuştur. Cinsel işlev bozuklukları ileri yaş, kadın cinsiyet, işsizlik, menopoz durumu ve eşlik eden diabetes mellitus varlığı ile ilişkili bulunmuştur. Hasta ve kontrol grupları arasında depresyon ve anksiyete düzeyleri açısından anlamlı bir fark saptanmamıştır. Akromegali hastalarında beden algısının belirgin şekilde daha bozulmuş olduğu ve bu bozulmanın daha yüksek depresyon ve anksiyete düzeyleri ile ilişkili olduğu gösterilmiştir. Ölçek puanları hastalık aktivitesine göre farklılık göstermemiştir. Tek değişkenli analizlerde GRISS toplam puanı ile IGF-1 ve serbest T4 düzeyleri arasında ters yönde ilişkiler saptanmış olmakla birlikte, çok değişkenli analizlerde IGF-1 düzeyleri cinsel işlev bozukluğu ile bağımsız olarak ilişkili bulunmamıştır. Sonuç olarak, akromegali hastalarının ruhsal bozukluklar ve cinsel işlev bozuklukları açısından riskli bir grup olduğu göz önünde bulundurularak, takip süreçlerinde bu hastaların psikopatoloji ve cinsel işlevler açısından rutin olarak sorgulanması önerilmektedir.

Anahtar Kelimeler

• akromegali
• depresyon
• anksiyete
• beden algısı
• cinsel disfonksiyon

Kaynakça

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