Autonomous Cortisol Secretion Influences Psychopathological Symptoms in Patients With Primary Aldosteronism

Gendreitzig, Pauline; Kuenzel, Heike E.; Adolf, Christian; Handgriff, Laura; Müller, Lisa; Holler, Finn; Sturm, Lisa; Heinrich, Daniel A.; Reincke, Martin und Quinkler, Marcus (2021): Autonomous Cortisol Secretion Influences Psychopathological Symptoms in Patients With Primary Aldosteronism. In: Journal of Clinical Endocrinology & Metabolism, Bd. 106, Nr. 6, E2423-E2433

Abstract

Context: Primary aldosteronism (PA) is associated with impaired quality of life (QoL). Autonomous cortisol cosecretion (ACS) is a relevant phenotype of PA, which could contribute to depression and anxiety disorders. This has not been investigated so far. Objective: To evaluate the prevalence of depression and anxiety in PA patients according to ACS. Methods: We performed testing for hypercortisolism and evaluated anxiety, depression and QoL by self-rating questionnaires in newly diagnosed PA patients of the German Conn's Registry;298 patients were reevaluated at follow-up. Results: In the overall cohort, scores for anxiety (P < .001), depression (P < .001), and QoL (mental P = .021;physical P = .015) improved significantly at follow-up. This improvement was seen in both subgroups of patients with and without ACS, with the exception of the mental subscore in no-ACS patients. Analysis for sex differences showed that anxiety decreased significantly in females with ACS and no-ACS, whereas males with no-ACS failed to improve. Depression improved significantly in males and females with ACS (P = .004, P = 0.011 respectively), but not in those with no-ACS. Physical subscore of QoL improved significantly (P = .023) in females with ACS and mental subscore (P = .027) in males with ACS, whereas no differences were seen for the no-ACS groups. Conclusion: Improvement in depression and anxiety scores in response to treatment of PA is more pronounced in patients with ACS in contrast to no-ACS suggesting a role of ACS in the psychopathological symptoms of patients with PA. Furthermore, we observed significant differences in depression and anxiety scores between the sexes.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0021-972X
• Sprache: Englisch