Higher state- and trait-anxiety in patients with pituitary adenomas compared to norm values of healthy controls

Context: Several studies reported psychiatric symptoms, e.g. increased rates of depression, for patients with pituitary adenomas.

Objective: Our aim was to explore state- and trait-anxiety in patients with different pituitary adenomas. Moreover we compared patient' anxiety values to norm values of healthy controls.

Design: Cross-sectional case-control study.

Setting: Endocrine Outpatient Unit of the Max Planck Institute of Psychiatry and the Department of Internal Medicine, Ludwig-Maximilians-University, in Munich.

Participants: We explored patients with Acromegaly (n= 68), with Non-functioning-pituitary-adenomas (NFMA) (n= 58), with Cushing disease (n= 64) and with Prolactinoma (n= 77) and compared patient' anxiety values to norm values of healthy adults (n= 1488). All differences between the four patient groups were controlled for differences in sex, age, body-mass-index (BMI) and depression.

Main Outcome Measure(s): Depression was measured by the Beck-Depression-Inventory (BDI). State- and trait-anxiety was assessed with the State-Trait-Anxiety-Inventory (STAI).

Results: Patients with Acromegaly, NFPA, Cushing-disease and Prolactinoma did not differ in state- and trait-anxiety (trait: F = 1.898, p = 0.130; state: F = 1.897, p = 0.130). But both – men and women with pituitary adenomas showed significantly higher anxiety values compared to the norm values of healthy controls (trait_men: t = 17.245, p < 0.001, trait_women: t = 16.549, p < 0.001; state_men: t = 11.576, p < 0.001, state_women: t = 17.532, p < 0.001).

Conclusions: These findings emphasize the importance of diagnosing and treating psychiatric symptoms as anxiety in patients with pituitary adenomas.