, Volume 21, Issue 3, pp 323–333 | Cite as

Cognitive-behavioral therapy improves the quality of life of patients with acromegaly

  • Lia Silvia Kunzler
  • Luciana Ansaneli Naves
  • Luiz Augusto Casulari



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.


Acromegaly 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.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Lia Silvia Kunzler
    • 1
  • Luciana Ansaneli Naves
    • 1
  • Luiz Augusto Casulari
    • 1
  1. 1.SRTVS 701BrasíliaBrazil

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