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Cognitive-behavioral therapy improves the quality of life of patients with acromegaly

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Abstract

Background

The delayed diagnosis, altered body image, and clinical complications associated with acromegaly impair quality of life.

Purpose

To assess the efficacy of the cognitive-behavioral therapy (CBT) technique “Think Healthy” to increase the quality of life of patients with acromegaly.

Methods

This non-randomized clinical trial examined ten patients with acromegaly (nine women and one man; mean age, 55.5 ± 8.4 years) from a convenience sample who received CBT. The intervention included nine weekly group therapy sessions. The quality of life questionnaire the 36-Item Short Form Survey (SF-36) and the Beck Depression Inventory (BDI) were administered during the pre- and post-intervention phases. The Wilcoxon signed-rank test was performed to assess the occurrence of significant differences.

Results

According to the SF-36, the general health domain significantly improved (d′  = − 0.264; p = 0.031). The mental health domain improved considerably (d′  = − 1.123; p = 0.012). Physical functioning showed a non-significant trend toward improvement (d′  = − 0.802; p = 0.078), although four of the five patients who showed floor effects improved and remained at this level. Regarding emotional well-being, five patients showed floor effects and four improved, and the condition did not change among any of the four patients who showed ceiling effects. No significant changes were found with regard to the other domains. No significant differences in the BDI were found before or after the intervention.

Conclusion

The technique presented herein effectively improved the quality of life of patients with acromegaly with different levels of disease activity, type, and treatment time.

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Acknowledgements

We thank Dr. Luis Augusto Dias for his critical review of this manuscript. We also thank Iago Renato Peixoto, Armindo Jreige Junior, Isabella Araujo, Débora Maria de C. Saraiva, and Vitoria Espindola L. Borges, medical students at the University of Brasília. This study was conducted at the neuroendocrinology outpatient clinic of the University Hospital of Brasília.

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Correspondence to Lia Silvia Kunzler.

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Kunzler, L.S., Naves, L.A. & Casulari, L.A. Cognitive-behavioral therapy improves the quality of life of patients with acromegaly. Pituitary 21, 323–333 (2018). https://doi.org/10.1007/s11102-018-0887-1

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