IGF-1 levels or medical treatment have no impact on psychosocial well-being of patients with acromegaly – results of a cross-sectional single-center survey

Objective: Normalization of serum IGF-1 by successful treatment of acromegaly can return life expectancy back to normal. Yet, control of GH/IGF-1 excess may not necessarily improve quality of life (QoL), which remains reduced compared to the general population. Hence, it was the aim of the present study to investigate possible differences in QoL and psychosocial well-being with regard to IGF-1 level and drug treatment and to investigate patients' subjective, most pressing disease burden.

Methods: Sub-analysis of a survey including 165 patients with acromegaly, operated between 2000 and 2012 in a large tertiary neurosurgical referral center in Germany. Patients completed a self-developed questionnaire on the course of the diagnostic process, current therapy and standardized self-rating questionnaires on QoL (SF-36), embitterment (BEI) and depression (BDI-II). Patients were asked about their disease symptoms and burden in free text options. Answers were categorized and counted.

Results: Elevated IGF-1 levels were reported by 15.8% patients, 52.7% reported normal IGF-1 levels and 31.5% did not know their last IGF-1 level. 122 patients answered the question of current drug treatment for acromegaly. Of those, 49.2% received medication, 50.8% were medication-free. Neither level of IGF-l nor receiving drugs resulted in statistically significant differences on any scales of the SF-36, BEI or BDI-II (p > 0.05). The most frequently mentioned symptom encumbrances of patients were enlargement of hands/feet, facial coarsening and a psychological symptom complex (tiredness, depression, reduced concentration).

Conclusion: We hypothesize that psychosocial impairment is governed by irreversible physical consequences of acromegaly. The prevalent psychological symptomatology may be attributed to a reactive depression subtype. More research into this matter is needed to implement treatment strategies that address patients' subjective requirements and accompany standard therapies.

*Equal contribution