Horm Metab Res 2018; 50(08): 620-626
DOI: 10.1055/a-0628-6847
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Psychological Symptoms and Well-Being After Treatment for Primary Aldosteronism

Marieke S. Velema
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
,
Jannie M. Terlouw
2   Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
,
Aline H. de Nooijer
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
,
Marjan D. Nijkamp
2   Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
,
Nele Jacobs
2   Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
3   Department Psychiatry and Neuropsychology Faculty of Health, Medicine and Life Sciences Maastricht University, Maastricht, The Netherlands
,
Jaap Deinum
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
› Author Affiliations
Further Information

Publication History

received 24 April 2018

accepted 26 April 2018

Publication Date:
12 June 2018 (online)

Abstract

Primary aldosteronism (PA) is an increasingly identified cause of secondary hypertension. PA can be caused by an aldosterone-producing adenoma or by bilateral adrenal hyperplasia, generally treated by adrenalectomy or mineralocorticoid receptor antagonists, respectively. Recent studies suggest that PA is associated with more psychological symptoms and lower levels of well-being. The purpose of this study was to investigate the associations between subtype of PA and psychological symptoms and well-being after specific treatment. We analyzed the outcomes of the Mental Health Continuum-Short Form and the Symptom Checklist in 160 patients (mean age 57 years; 74.3% males) with PA, comparing the scores for psychological symptoms and well-being between both subtypes of PA. Additionally, we performed subgroup analyses based on gender, age, time since initiation of treatment, and co-morbidity. Moreover, we compared the results with published norm scores. Mean follow-up after adrenalectomy or start of medication was four years and two months. Depressive symptoms, anxiety and obsessive-compulsive thoughts and well-being did not differ between subtypes of PA. Subgroup analysis did not reveal any differences, except for women with bilateral adrenal hyperplasia who scored higher on the anxiety subscale than women after adrenalectomy. Compared to the general population, patients with treated PA reported more psychological symptoms. In contrast, well-being did not differ significantly from norm scores. Subtype and treatment of PA were no important determinants of psychological symptoms and well-being on the long-term. We suggest that physicians should be alert for psychological symptoms, as these were more frequently present in patients with PA.

Supplementary Material

 
  • References

  • 1 Käyser SC, Dekkers T, Groenewoud HJ, van der Wilt GJ, Carel Bakx J, van der Wel MC, Hermus AR, Lenders JW, Deinum J. Study heterogeneity and estimation of prevalence of primary aldosteronism: A systematic review and meta-regression analysis. J Clin Endocrinol Metab 2016; 101: 2826-2835
  • 2 Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, Stowasser M, Joung Jr WF. The management of primary aldosteronism: Case detection, diagnosis, and treatment: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016; 101: 1899-1916
  • 3 Milliez P, Girerd X, Plouin PF, Blacher J, Safar ME, Mourad JJ. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol 2005; 45: 1243-1248
  • 4 Apostolopoulou K, Kunzel HE, Gerum S, Merkle K, Schulz S, Fischer E, Pallauf A, Brand V, Bidlingmaier M, Enders S, Beuschlein F, Reincke M. Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: A cross-sectional study. World J Biol Psychiatry 2014; 15: 26-35
  • 5 Sonino N, Tomba E, Genesia ML, Bertello C, Mulatero P, Veglio F, Fava GA, Fallo F. Psychological assessment of primary aldosteronism: A controlled study. J Clin Endocrinol Metab 2011; 96: E878-E883
  • 6 Velema MS, de Nooijer AH, Burgers VWG, Hermus A, Timmers H, Lenders JWM, Husson O, Deinum J. Health-related quality of life and mental health in primary aldosteronism: A systematic review. Horm Metab Res 2017; 49: 943-950
  • 7 Ahmed AH, Gordon RD, Sukor N, Pimenta E, Stowasser M. Quality of life in patients with bilateral primary aldosteronism before and during treatment with spironolactone and/or amiloride, including a comparison with our previously published results in those with unilateral disease treated surgically. J Clin Endocrinol Metab 2011; 96: 2904-2911
  • 8 Sukor N, Kogovsek C, Gordon RD, Robson D, Stowasser M. Improved quality of life, blood pressure, and biochemical status following laparoscopic adrenalectomy for unilateral primary aldosteronism. J Clin Endocrinol Metab 2010; 95: 1360-1364
  • 9 Catena C, Colussi G, Lapenna R, Nadalini E, Chiuch A, Gianfagna P, Sechi LA. Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 2007; 50: 911-918
  • 10 Williams TA, Lenders JWM, Mulatero P, Burrello J, Rottenkolber M, Adolf C, Adolf C, Satoh F, Amar L, Quinkler M, Deinum J, Beuschlein F, Kitamoto KK, Pham U, Morimoto R, Umakoshi H, Prejbisz A, Kocjan T, Naruse M, Stowasser M, Nishikawa T, Young Jr. WF, Gomez-Sanchez CE, Funder JW, Reincke M. Primary Aldosteronism Surgery Outcome (PASO) investigators . Outcomes after adrenalectomy for unilateral primary aldosteronism: An international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol 2017; 5: 689-699
  • 11 Velema M, Dekkers T, Hermus A, Timmers H, Lenders J, Groenewoud H, Schultze Kool L, Langenhuijsen J, Prejbisz A, van der Wilt GJ, Deinum J. SPARTACUS Investigators . Quality of life in primary aldosteronism: A comparative effectiveness study of adrenalectomy and medical treatment. J Clin Endocrinol Metab 2018; 103: 16-24
  • 12 Hanusch FM, Fischer E, Lang K, Diederich S, Endres S, Allolio B, Beuschlein F, Reincke M, Quinkler M. Sleep quality in patients with primary aldosteronism. Hormones 2014; 13: 5764
  • 13 Tsuchimochi S, Nakajo M, Nakajo M, Tanabe H, Umanodan T, Nakabeppu Y. Comparison of cerebral blood flow and mental states before and after therapy in primary aldosteronism. Eur J Nucl Med 2001; 28: 1216-1216
  • 14 Kunzel HE, Apostolopoulou K, Pallauf A, Gerum S, Merkle K, Schulz S, Fischer E, Brand V, Bidlingmaie M, Endres S, Beuschlein F, Reincke M. Quality of life in patients with primary aldosteronism: Gender differences in untreated and long-term treated patients and associations with treatment and aldosterone. J Psychiatr Res 2012; 46: 1650-1654
  • 15 Arrindel WA, Ettema JH. Symptom Checklist: Handleiding bij een multidimensionele psychopathologie indicator. Pearson Assessment and Information B.V 2003
  • 16 Lamers SM, Westerhof GJ, Bohlmeijer ET, ten Klooster PM, Keyes CL. Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). J Clin Psychol 2011; 67: 99-110
  • 17 Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: A new method to assess comorbidity for clinical and health services research. Arthritis Rheum 2003; 49: 156-163
  • 18 Stolwijk C, van Tubergen A, Ramiro S, Essers I, Blaauw M, van der Heijde D, Landewe R, van den Bosch F, Dougados M, Boonen A. Aspects of validity of the self-administered comorbidity questionnaire in patients with ankylosing spondylitis. Rheumatology (Oxford) 2014; 53: 1054-1064
  • 19 Sonderen Ev. Omgaan met ontbrekende gegevens in het bijzond bij schaalitems. Verpleegkunde 2000; 15: 104-111
  • 20 MacKenzie SM, Lai M, Clark CJ, Fraser R, Gomez-Sanchez CE, Seckl JR, Connell JM, Davies E. 11beta-hydroxylase and aldosterone synthase expression in fetal rat hippocampal neurons. J Mol Endocrinol 2002; 29: 319-325
  • 21 Heald AH, Ghosh S, Bray S, Gibson C, Anderson SG, Buckler H, Fowler HL. Long-term negative impact on quality of life in patients with successfully treated Cushing's disease. Clin Endocrinol (Oxf) 2004; 61: 458-465
  • 22 Tiemensma J, Kokshoorn NE, Biermasz NR, Keijser BJ, Wassenaar MJ, Middelkoop HA, Pereira AM, Romijn JA. Subtle cognitive impairments in patients with long-term cure of Cushing's disease. J Clin Endocrinol Metab 2010; 95: 2699-2714
  • 23 Arlt W, Lang K, Sitch AJ, Dietz AS, Rhayem Y, Bancos I, Feuchtinger A, Chortis V, Gilligan LC, Ludwig P, Riester A, Asbach E, Hughes BA, O'Neil DM, Bidlingmaier M, Tomlinson JW, Hassan-Smith ZK, Rees DA, Adolf C, Hahner S, Quinkler M, Dekkers T, Deinum J, Biehl M, Keevil BG, Shackleton CHL, Deeks JJ, Walch AK, Beuschlein F, Reincke M. Steroid metabolome analysis reveals prevalent glucocorticoid excess in primary aldosteronism. JCI Insight 2017; 2 pii: 93136 DOI: 10.1172/jci.insight.93136. [Epub ahead of print]
  • 24 Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003; 41: 582-592
  • 25 Pang TC, Bambach C, Monaghan JC, Sidhu SB, Bune A, Delbridge LW, Sywak MS. Outcomes of laparoscopic adrenalectomy for hyperaldosteronism. ANZ J Surg 2007; 77: 768-773
  • 26 Tresallet C, Salepcioglu H, Godiris-Petit G, Hoang C, Girerd X, Menegaux F. Clinical outcome after laparoscopic adrenalectomy for primary hyperaldosteronism: the role of pathology. Surgery 2010; 148: 129-134
  • 27 Sonino N, Fallo F, Fava GA. Psychological aspects of primary aldosteronism. Psychother Psychosom 2006; 75: 327-330
  • 28 Higa M, Sasano H, Kakazu M, Shimabuku M. The relationship between primary aldosteronism and anxiety or panic disorder. Endocr J 2010; 57: S640-S640
  • 29 Camfield L, Skevington SM. On subjective well-being and quality of life. J Health Psychol 2008; 13: 764-775
  • 30 Spiro 3rd A, Bosse R. Relations between health-related quality of life and well-being: the gerontologist's new clothes?. Int J Aging Hum Dev 2000; 50: 297-318
  • 31 Keyes CL, Wissing M, Potgieter JP, Temane M, Kruger A, van Rooy S. Evaluation of the mental health continuum-short form (MHC-SF) in setswana-speaking South Africans. Clin Psychol Psychother 2008; 15: 181-192
  • 32 Nanba AT, Nanba K, Byrd JB, Shields JJ, Giordano TJ, Miller BS, Rainey WE, Auchus RJ, Turcu AF. Discordance between imaging and immunohistochemistry in unilateral primary aldosteronism. Clin Endocrinol (Oxf) 2017; 87: 665-672