Cushing Syndrome Results in Poor Quality of Life Even After Remission

Functional remission did not occur in most patients with Cushing syndrome who were considered to be in biochemical and clinical remission, according to a study published in Endocrine. This was evidenced by their quality of life, which remained impaired in all domains.

The term “functional remission” is a psychiatric concept that is defined as an “association of clinical remission and a recovery of social, professional, and personal levels of functioning.” In this observational study, investigators sought to determine the specific weight of psychological (anxiety and mood, coping, self-esteem) determinants of quality of life in patients with Cushing syndrome who were considered to be in clinical remission.

The cohort included 63 patients with hypercortisolism currently in remission who completed self-administered questionnaires that included quality of life (WHOQoL-BREF and Cushing QoL), depression, anxiety, self-esteem, body image, and coping scales. At a median of 3 years since remission, participants had a significantly lower quality of life and body satisfaction score compared with the general population and patients with chronic diseases. Of the cohort, 39 patients (61.9%) reported having low or very low self-esteem, while 16 (25.4%) had high or very high self-esteem. Depression and anxiety were seen in nearly half of the patients and they were more depressed than the general population. In addition, 42.9% of patients still needed working arrangements, while 19% had a disability or cessation of work.

Investigators wrote, “This impaired quality of life is strongly correlated to neurocognitive damage, and especially depression, a condition that is frequently confounded with the poor general condition owing to the decreased levels of cortisol. A psychiatric consultation should thus be systematically advised, and [selective serotonin reuptake inhibitor] therapy should be discussed.”

Reference

Vermalle M, Alessandrini M, Graillon T, et al.  Lack of functional remission in Cushing’s Syndrome [published online July 17, 2018]. Endocrine. doi:10.1007/s12020-018-1664-7

From https://www.endocrinologyadvisor.com/general-endocrinology/functional-remission-quality-of-life-cushings-syndrome/article/788501/

2 Responses

  1. So given this is a negative, post treatment condition, only the option of drug therapy with serotonin re-uptake medicine is all the therapy there is ?! What of any physical and social therapy? Is there only drugs like
    Prozac I was prescribed but declined to take? Why? This is disastrous for people like me with a long term experience with Cushings disease with multiple complications including a subdural hematoma and stroke.
    What can I do to to improve my life? Educating others about Cushing’s gives no support for the patient and medical science is still very behind in understanding what Cushings disease is let alone diagnosis. No wonder so many suffer alone after treatment is only maintaining the remaining functioning of post disease with no support resources.

    • Actually, many Cushing’s patients like articles like this to take to their doctors to help them get better answers.

      There are several “branches” to the Cushings-Help site. This is the one that posts news items, good or bad.

      We’ve offered support on the Message Boards for over 18 years now. Find them at http://cushings.invisionzone.com/ There’s also a Facebook for those who are more involved with that platform.

      There are practical tips on the CushieWiki at http://www.cushings-info.com/index.php?title=Main_Page

      Bios of people going through the same symptoms/surgeries/issues can be found at https://cushingsbios.com

      Personally, was prescribed Xanax, which I also didn’t take because I knew it would hide my symptoms, making my diagnosis even harder – even though I’d already told several doctors that I was sure I had Cushing’s.

      When I had Cushing’s in the early 1980’s, I was truly alone until I got to the NIH. These days, thanks to the Internet, there’s lots of help available.

      Best of luck to you!

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