Psychological distress in patients with hyperprolactinaemia
OBJECTIVE In addition to the physical symptoms of galactorrhoea and amenorrhoea, hyperprolactinaemia in women is also reported to be associated with psychological symptoms. Previous studies have found an increased incidence of depression, anxiety and hostility in female patients with hyperprolactina...
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| Published in: | Clinical endocrinology (Oxford) Vol. 47; no. 3; pp. 343 - 348 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Oxford, UK
Blackwell Science Ltd
01-09-1997
Blackwell |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | OBJECTIVE
In addition to the physical symptoms of galactorrhoea and amenorrhoea, hyperprolactinaemia in women is also reported to be associated with psychological symptoms. Previous studies have found an increased incidence of depression, anxiety and hostility in female patients with hyperprolactinaemia. In this study, psychological symptoms were assessed in a large population of patients and symptom scores were compared between patients with definite evidence of pituitary adenoma on high‐resolution CT scanning and those without, who were presumed to have idiopathic or ‘functional’ hyperprolactinaemia.
DESIGN
Postal survey: population–control study of female patients with hyperprolactinaemia.
PATIENTS
Sixty‐five women with hyperprolactinaemia were compared with a control group of 26 women with normoprolactinaemic pituitary disease (acromegaly or nonfunctioning pituitary adenoma). The hyperprolactinaemic patients were subdivided according to whether a pituitary adenoma was visible on high‐resolution CT scanning (39 patients) or whether they had normal CT scans, in which case they were categorized as having idiopathic or ‘functional’ hyperprolactinaemia (26 patients).
MEASUREMENTS
Patients were sent 2 questionnaires, the Hospital Anxiety and Depression (HAD) Scale and the 90‐item Symptom Checklist (SCL‐90), to assess psychological wellbeing.
RESULTS
Overall, 54% of hyperprolactinaemic patients were found to have definite or borderline anxiety as judged by HAD scores, compared with 27% of normoprolactinaemic control patients. Those with normal CT scans were significantly more likely to have definite or borderline anxiety (73% of patients) than those with CT evidence of a pituitary tumour causing their hyperprolactinaemia (41%, P < 0.003), despite similar levels of serum prolactin. A similar increased proportion of hyperprolactinaemic patients scored highly on the anxiety component of the SCL‐90, although mean scores were not different from controls. No differences were seen in scores for depression, but both subgroups of hyperprolactinaemic patients scored more highly than controls for hostility on the SCL‐90 questionnaire.
CONCLUSION
These findings confirm the presence of significant anxiety in a proportion of women with hyperprolactinaemia. Hyperprolactinaemic women with no abnormality on CT scans displayed more psychological distress than those with definite pituitary microadenomas. These results may provide insight into the pathogenesis of ‘functional’ hyperprolactinaemia. |
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| Bibliography: | ark:/67375/WNG-BXJ67DVD-5 ArticleID:CEN270 istex:05FBD33501E3E1233562FAEB93F7391BD3833CFB ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0300-0664 1365-2265 |
| DOI: | 10.1046/j.1365-2265.1997.2701073.x |