Acromegalic patients: more depressed, without panic? The 'endocrine psychosyndrome' of acromegaly revised

GH/IGF-1 are growth promoting factors with pleiotropic functions on the brain. In acromegalic patients, personality changes sometimes referred to as 'endocrine psychosyndrome' have been noted, but no systematic investigation including in-vivo neural correlates have been presented so far. In this interdisciplinary study we assessed acromegalic patients including standardized computer-based psychopathological and neuropsychological assessments as well as magnetic resonance imaging in subset of patients. Preliminary results on 65 patients with clinically manifest acromegaly point to an increased lifetime prevalence of affective disorders of 42.9% (mainly major depressive episodes and dysthymia) compared to 21.4% in 3281 control patients with chronic somatic disorders (OR 2,88, CI 1.59–5.21). In 76.9% of the cases, the psychiatric conditions occurred before the diagnosis of acromegaly (but after the estimated onset of the disease). Interestingly, not even one acromegalic patient had ever suffered from a panic attack compared to the expected prevalence of 9.1%. Detailed neuropsychological examination revealed impairments in several areas indicating global rather than specific cognitive dysfunction. In conclusion, data so far point to a shifted risk profile of acromegaly to go along with neuropsychological impairments and affective disorders, differing from the profile generally associated with chronic somatic disorders.

This study was supported by Pfizer Pharma GmbH