THE EFFECT OF TREATMENT VARIABLES ON MOOD AND SOCIAL-ADJUSTMENT IN ADULT PATIENTS WITH PITUITARY DISEASE

OBJECTIVE Studies of mood in hypopituitary adults have yielded inconsi stent results. This investigation was carried out to investigate wheth er treatment characteristics may be responsible for the inconsistent r esults. DESIGN AND MEASUREMENTS We compared three groups of patients w ith a group of matched healthy controls on self-report measures of moo d and social adjustment (Beck depression inventory, State-trait anxiet y inventory, Social adjustment scale (modified)) and a measure of qual ity of life (Nottingham health profile, NHP). PATIENTS The patient gro ups were those treated with transfrontal surgery (n = 23), transspheno idal surgery (n = 23) or medication only (n = 23), in addition, a clos e informant of each subject was asked to complete a social adjustment measure about the subject's lever of adjustment. RESULTS On the self-r eport mood and social adjustment measures and the emotion sub-scale of the NHP, the transsphenoidal and medication patient groups rated them selves as being more depressed, anxious and having poorer social adjus tment than the transfrontal or control groups. The close informants, h owever, rated all three patient groups as having poorer social adjustm ent than the controls. Patients treated with surgery and without radio therapy reported fewer symptoms of depression than those treated with radiotherapy. Realistic self-appraisal of social adjustment in surgica l patients was found only in those treated with transsphenoidal surger y without radiotherapy. CONCLUSIONS Patients treated for pituitary tum our, excepting those treated with transfrontal surgery and to a lesser extent those treated with radiotherapy, suffer from mild mood disturb ance and self-perceived decreased social adjustment. All patient group s are seen by others as having decreased social adjustment, raising th e possibility that the transfrontal patients and possibly those who ha ve had radiotherapy, lack insight. This may explain some of the discre pancies in the previous literature and needs to be taken into account when using self-report measures with these patients.