Skip to main content

Advertisement

Log in

Mental health disorders in newly diagnosed non-functional pitutary adenoma under initial observation: an observational cohort study using the nationwide MarketScan database

  • Published:
Pituitary Aims and scope Submit manuscript

Abstract

Purpose

Nonfunctioning pituitary adenomas account for 15–30% of pituitary tumors. Studies exploring the role of an intracranial tumor diagnosis, specifically nonfunctioning pituitary adenomas, on mental health disorders (MHDs) in patients have been limited. We characterize the incidence and factors affecting the development of MHDs in untreated pituitary adenomas.

Methods

Utilizing a large-scale private payor database, MarketScan, we performed a retrospective study of patients with an untreated pituitary adenomas and corresponding MHD.

Results

We found that in patients diagnosed with an untreated pituitary adenomas, approximately 15% were newly diagnosed with a MHD within 1 year of the pituitary adenoma diagnosis. Independent risk factors included female gender and substance abuse. Headaches, visual symptoms, and higher Charlson Co-morbidity indexes were also independently associated with a subsequent diagnosis of MHD. On multivariable analysis, patients in the pituitary tumor cohort were more likely to be diagnosed with a MHD than those in the matched cohort (aOR: 1.31, CI: 1.19–1.44).

Conclusion

By identifying risk factors, advanced screening can focus on non-operative pituitary adenoma patients at high-risk for the development of MHD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Raappana A, Koivukangas J, Ebeling T, Pirila T (2010) Incidence of pituitary adenomas in Northern Finland in 1992–2007. J Clin Endocrinol Metab 95(9):4268–4275

    Article  CAS  Google Scholar 

  2. Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A (2006) High prevalence of pituitary adenomas: a cross-sectional study in the province of Liège, Belgium. J Clin Endocrinol Metab 91(12):4769–4775

    Article  CAS  Google Scholar 

  3. Fernandez A, Karavitaki N, Wass JA (2010) Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol (Oxf) 72(3):377–382

    Article  Google Scholar 

  4. Melmed S (2020) Pituitary-tumor endocrinopathies. NEJM 382:937–950. https://doi.org/10.1056/NEJMra1810772

    Article  CAS  PubMed  Google Scholar 

  5. Ntali G, Capatina C, Fazal-Sanderson V et al (2016) Mortality in patients with non-functioning pituitary adenoma is increased: systematic analysis of 546 cases with long follow-up. EJE 174(2):137–145

    Article  CAS  Google Scholar 

  6. Chanson P, Raverot G, Castinetti F et al (2015) Management of clinically non-functioning pituitary adenoma. Ann Endocrinol (Paris) 76(3):239–247. https://doi.org/10.1016/j.ando.2015.04.002

    Article  Google Scholar 

  7. Rooney AG, Carson A, Grant R (2011) Depression in cerebral glioma patients: a systematic review of observational studies. J Natl Cancer Inst 103:61–76

    Article  Google Scholar 

  8. Huang J, Zeng C, Xiao J, Zhao D, Tang H, Wu H, Chen J (2017) Association between depression and brain tumor: a systematic review and meta-analysis. Oncotarget 8:94932–94943

    Article  Google Scholar 

  9. Goebel S, Mehdorn HM (2013) Development of anxiety and depression in patients with benign intracranial meningiomas: a prospective long-term study. Support Care Cancer 21:1365–1372

    Article  Google Scholar 

  10. Mainio A, Hakko H, Niemela A, Koivukangas J, Rasanen P (2005) Depression and functional outcome in patients with brain tumors: a population-based 1-year follow-up study. J Neurosurg 103:841–847

    Article  Google Scholar 

  11. Bunevicius A, Tamasauskas S, Deltuva V, Tamasauskas A, Radziunas A, Bunevicius R (2014) Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective. Acta Neurochir 156:367–374

    Article  Google Scholar 

  12. Pringle AM, Taylor R, Whittle IR (1999) Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. Br J Neurosurg 13:46–51

    Article  CAS  Google Scholar 

  13. van der Vossen S, Schepers VP, Berkelbach van der Sprenkel JW, Visser-Meily JM, Post MW (2014) Cognitive and emotional problems in patients after cerebral meningioma surgery. J Rehabil Med 46:430–437

    Article  Google Scholar 

  14. Gathinji M, McGirt MJ, Attenello FJ et al (2009) Association of preoperative depression and survival after resection of malignant brain astrocytoma. Surg Neurol 71(3):299–303

    Article  Google Scholar 

  15. Mainio A, Tuunanen S, Hakko H, Niemelä A, Koivukangas J, Räsänen P (2006) Decreased quality of life and depression as predictors for shorter survival among patients with low-grade gliomas: a follow-up from 1990 to 2003. Eur Arch Psychiatry Clin Neurosci 256(8):516–521

    Article  Google Scholar 

  16. IBM (2019) IBM MarketScan research database for health services researchers white paper. IBM, Armonk

    Google Scholar 

  17. Lee JH, Ba D, Liu G, Leslie D, Zacharia BE, Goyal N (2019) Association of head and neck cancer with mental health disorders in a large insurance claims database. JAMA Otolaryngol Head Neck Surg 145(4):339–344. https://doi.org/10.1001/jamaoto.2018.4512

    Article  PubMed  PubMed Central  Google Scholar 

  18. Maurer R, Daggubati L, Ba D, Liu G, Leslie D, Goyal N, Zacharia B (2020) Mental health disorders in patients with untreated meningiomas: an observational cohort study using the nationwide MarketScan database. Neuro-Oncol Pract. https://doi.org/10.1093/nop/npaa025

    Article  Google Scholar 

  19. D’Angelo C, Mirijello A, Leggio L, Ferrulli A, Carotenuto V, Icolaro N, Miceli A, D’Angelo V, Gasbarrini G, Addolorato G (2008) State and trait anxiety and depression in patients with primary brain tumors before and after surgery: 1-year longitudinal study. J Neurosurg 108:281–286

    Article  Google Scholar 

  20. Kessler RC, Ormel J, Petukhova M et al (2011) Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 68:90

    Article  Google Scholar 

  21. Greenberg PE, Fournier AA, Sisitsky T et al (2015) The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry 76:155

    Article  Google Scholar 

  22. Compton WM, Conway KP, Stinson FS, Grant BF (2006) Changes in the prevalence of major depression and comorbid substance use disorders in the United States between 1991–1992 and 2001–2002. Am J Psychiatry 163:2141

    Article  Google Scholar 

  23. Kendler KS, Gardner CO, Prescott CA (2006) Toward a comprehensive developmental model for major depression in men. Am J Psychiatry 163:115

    Article  Google Scholar 

  24. Mainio A, Hakko H, Timonen M, Niemelä A, Koivukangas J, Räsänen P (2005) Depression in relation to survival among neurosurgical patients with primary brain tumor: a 5-year follow-up study. Neurosurgery 56:1234–1242

    Article  Google Scholar 

  25. Litofsky NS, Farace E, Anderson F, Meyers CA, Huang W, Laws ER (2004) Depression in patients with high-grade glioma: results of the glioma outcome project. Neurosurgery 54:358–366

    Article  Google Scholar 

  26. Wei LF, Cai L, Wu ZB (2016) Quality of life of patients with nonfunctioning pituitary adenoma: a meta-analysis. Zhonghua Yi Xue Za Zhi 96(19):1481–1484. https://doi.org/10.3760/cma.j.issn.0376-2491.2016.19.004

    Article  CAS  PubMed  Google Scholar 

  27. Vega-Beyhart A, Enriquez-Estrada VM, Bello-Chavolla OY et al (2019) Quality of life is significantly impaired in both secretory and non-functioning pituitary adenomas. Clin Endocrinol (Oxf) 90(3):457–467. https://doi.org/10.1111/cen.13915

    Article  CAS  Google Scholar 

  28. Johnson MD, Woodburn CJ, Vance ML (2003) Quality of life in patients with a pituitary adenoma. Pituitary 6(2):81–87. https://doi.org/10.1023/b:pitu.0000004798.27230.ed

    Article  PubMed  Google Scholar 

  29. Kessler RC, Berglund P, Demler O et al (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593

    Article  Google Scholar 

  30. Kessler RC, Gruber M, Hettema JM et al (2008) Co-morbid major depression and generalized anxiety disorders in the National Comorbidity Survey follow-up. Psychol Med 38:365

    Article  CAS  Google Scholar 

  31. Kendler KS, Gatz M, Gardner CO, Pedersen NL (2006) A Swedish national twin study of lifetime major depression. Am J Psychiatry 163:109

    Article  Google Scholar 

  32. Seedat S, Scott KM, Angermeyer MC et al (2009) Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 66(7):785–795

    Article  Google Scholar 

  33. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284(20):2606–2610

    Article  CAS  Google Scholar 

  34. Steinberg ML, Williams JM, Li Y (2015) Poor mental health and reduced decline in smoking prevalence. Am J Prev Med 49(3):362–369

    Article  Google Scholar 

Download references

Funding

The authors declare that this project received no funding.

Author information

Authors and Affiliations

Authors

Contributions

NG, BEZ: Conception and Design. DMB, GL, DL: Acquisition of Data. RM, SM, LD, DMB, GL, DL: Analysis and Interpretation of Data. RM, SM, LD: Drafting the Article. RM, NG, BEZ: Critically Revising the Article. RM, SM, LD, DMB, GL, DL, NG, BEZ: Reviewed submitted version of manuscript. RM, BEZ: Approved the final version of the manuscript on behalf of all authors. DMB, GL, DL: Statistical analysis—if applicable. DMB, GL, DL, BEZ: Administrative/technical/material support. NG, BEZ: Study supervision.

Corresponding author

Correspondence to Brad E. Zacharia.

Ethics declarations

Conflict of interest

Dr. Brad Zacharia declares the following Conflicts of Interest, neither of which are related to this manuscript: NICO Corp- Speakers Fees, Medtronic Inc- Consultant. Dr. Neerav Goyal declares the following Conflicts of Interest, none of which are related to this manuscript: Medrobotics Corp – Grant funding, Thieme Inc – book royalties.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maurer, R., McNutt, S., Daggubati, L.C. et al. Mental health disorders in newly diagnosed non-functional pitutary adenoma under initial observation: an observational cohort study using the nationwide MarketScan database. Pituitary 25, 85–91 (2022). https://doi.org/10.1007/s11102-021-01172-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11102-021-01172-1

Keywords

Navigation