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Quality of life in Cushing’s syndrome

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Abstract

Introduction

Cushing syndrome (CS) of any etiology (adrenal, pituitary or ectopic) impacts negatively on health-related quality of life (QoL), especially in active hypercortisolism but also after endocrine cure. Both generic questionnaires like the short-form 36 health survey -SF-36- and the derived SF-12, or the Hospital Anxiety and Depression Scale (HADS), and disease-specific measures like the CushingQoL and the Tuebingen CD-25 questionnaires have provided information on the impact of CS on patients perceived health.

Materials and methods

Studies published since January 2013 until November 2014 on QoL in patients with CS were identified, reviewed and summarized.

Conclusions

Treatment of CS improves patients perceived QoL, but it often takes many months and often never normalizes. In parallel to persistent QoL impairment in cured CS, brain and cerebellar volume are reduced. Depression, anxiety and cognitive dysfunction are common. Pediatric patients with CS also present worse QoL than normal children, as well as additional issues like delayed growth and pubertal development, next to abnormal body composition, psychological and cognitive maturation. Fluoxetine has been suggested as a neuroprotectant and antidepressant for patients with CS, although no prospective studies are yet available. The CushingQoL questionnaire has been mapped to well-validated instruments like SF-36 or EQ-5D, and therefore may be used in cost-utility and other health economy studies.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Endocrinology/Medicine Departments, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII, Hospital Sant Pau, Barcelona, Spain

    Alicia Santos, Iris Crespo, Anna Aulinas, Eugenia Resmini, Elena Valassi & Susan M. Webb

  2. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain

    Alicia Santos, Iris Crespo, Anna Aulinas, Eugenia Resmini, Elena Valassi & Susan M. Webb

  3. Department of Endocrinology, Hospital Sant Pau, Pare Claret 167, 08025, Barcelona, Spain

    Susan M. Webb

Authors
  1. Alicia Santos
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  2. Iris Crespo
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  3. Anna Aulinas
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  4. Eugenia Resmini
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  5. Elena Valassi
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  6. Susan M. Webb
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Correspondence to Susan M. Webb.

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Santos, A., Crespo, I., Aulinas, A. et al. Quality of life in Cushing’s syndrome. Pituitary 18, 195–200 (2015). https://doi.org/10.1007/s11102-015-0640-y

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  • DOI: https://doi.org/10.1007/s11102-015-0640-y

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