Cognitive-behavioral therapy improves the quality of life of patients with acromegaly
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The delayed diagnosis, altered body image, and clinical complications associated with acromegaly impair quality of life.
To assess the efficacy of the cognitive-behavioral therapy (CBT) technique “Think Healthy” to increase the quality of life of patients with acromegaly.
This non-randomized clinical trial examined ten patients with acromegaly (nine women and one man; mean age, 55.5 ± 8.4 years) from a convenience sample who received CBT. The intervention included nine weekly group therapy sessions. The quality of life questionnaire the 36-Item Short Form Survey (SF-36) and the Beck Depression Inventory (BDI) were administered during the pre- and post-intervention phases. The Wilcoxon signed-rank test was performed to assess the occurrence of significant differences.
According to the SF-36, the general health domain significantly improved (d′ = − 0.264; p = 0.031). The mental health domain improved considerably (d′ = − 1.123; p = 0.012). Physical functioning showed a non-significant trend toward improvement (d′ = − 0.802; p = 0.078), although four of the five patients who showed floor effects improved and remained at this level. Regarding emotional well-being, five patients showed floor effects and four improved, and the condition did not change among any of the four patients who showed ceiling effects. No significant changes were found with regard to the other domains. No significant differences in the BDI were found before or after the intervention.
The technique presented herein effectively improved the quality of life of patients with acromegaly with different levels of disease activity, type, and treatment time.
KeywordsAcromegaly Quality of life SF-36 Depression Cognitive-behavioral therapy
We thank Dr. Luis Augusto Dias for his critical review of this manuscript. We also thank Iago Renato Peixoto, Armindo Jreige Junior, Isabella Araujo, Débora Maria de C. Saraiva, and Vitoria Espindola L. Borges, medical students at the University of Brasília. This study was conducted at the neuroendocrinology outpatient clinic of the University Hospital of Brasília.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 3.Dantas RAE, Passos KE, Porto LB, Zakir JCO, Reis MC, Naves LA (2013) Physical activities in daily life and physical functioning compared to disease activity control in acromegalic patients: impact in self-reported quality of life. Arq Bras Endocrinol Metabol 57(7):550–557CrossRefPubMedGoogle Scholar
- 4.Abreu A, Tovar AP, Castellanos R, Valenzuela A, Giraldo CMG, Pinedo AC, Guerrero DP, Barrera CAB, Franco HI, Ribeiro-Oliveira A, Vilar L, Jallad RS, Duarte FG, Gadelha M, Boguszewski CL, Abucham J, Naves LA, Musolino NRC, de Faria MEJ, Rossato C, Bronstein MD (2016) Challenges in the diagnosis and management of acromegaly: a focus on comorbidities. Pituitary 19(4):448–457CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Leon-Carrion J, Martin-Rodriguez JF, Madrazo-Atutxa A, Soto-Moreno A, Venegas-Moreno E, Torres-Vela E, Benito-López P, Gálvez MA, Tinahones FJ, Leal-Cerro A (2010) Evidence of cogniitve and neurophysiological impairment in patientswith untreated naive acromegaly. J Clin Endocrinol Metab 95(9):4367–4379CrossRefPubMedGoogle Scholar
- 25.Geraedts VJ, Dimopoulou C, Auer M, Schopohl J, Stalla GK, Sievers C (2014) Health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life. Front Endocrinol 5:229Google Scholar
- 37.Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR (1999) Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol 39(3):143–150Google Scholar
- 39.Ferreira de Lima MCGP, Kunzler LS (2017) Terapia cognitivo-comportamental nas doenças reumáticas. Capital Reum 19(3):14–19Google Scholar
- 41.Cunha JA (2001) Manual da versão em Português das Escalas Beck. Casa do Psicólogo, São PauloGoogle Scholar
- 42.IV Diretrizes Brasileiras de Hipertensão Arterial (2004) Arq Bras Cardiol 82(Supl 4):7–22Google Scholar
- 45.Gibbons J, Chakraborti S (2011) Nonparametric statistical inference, 5 edn. Taylor & Francis, New YorkGoogle Scholar
- 50.Butler G, Hope T (2007) Managing your mind: the mental fitness guide, 2nd edn. Oxford University Press, New YorkGoogle Scholar
- 53.Postma MK, Netea-Maier RT, Van den Bergh G, Homan J, Sluiter WJ, Wagenmakers MA, van den Bergh ACM, Wolffenbuttel BHR, Hermus ARM (2012) Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly. Eur J Endocrinol 166:585–592CrossRefPubMedGoogle Scholar
- 55.Yoshida K, Fukuoka H, Matsumoto R, Bando H, Suda K, Nishizawa H, Takahashi Y (2015) The quality of life in acromegalic patients with biochemical remission by surgery alone is superior to that in those with pharmaceutical therapy without radiotherapy, using the newly developed Japanese version of the AcroQoL. Pituitary 18(6):876–883CrossRefPubMedGoogle Scholar
- 59.Vilar L, Abucham J, Albuquerque JL, Araujo LA, Azevedo MF, Boguszewski CL, Casulari LA, Cunha Neto MBC, Czepielewski MA, Duarte FHG, Faria MS, Gadelha MR, Garmes HM, Glezer A, Gurgel MH, Jallad RS, Miranda PAC, Montenegro RM, Musolino NRC, Naves LA, Oliveira Júnior AR, Silva CMS, Viecceli C, Bronstein MD (2018) Controversial issues in the management of hyperprolactinemia and prolactinomas—an overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism. Arch Endocrinol MetabGoogle Scholar
- 60.Passos KE (2013) Avaliação do perfil psicopatológico e da qualidade de vida em pacientes acromegálicos [Dissertation]. Brasília: Universidade de BrasíliaGoogle Scholar
- 61.Sá AMG (2017) Fatores associados com a qualidade de vida e avaliação dos sintomas de ansiedade e depression dos pacientes acromegálicos [Thesis]. São Luis: Universidade Federal do MaranhãoGoogle Scholar