ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

The Effects of Psychological Focus Group Therapy on the Quality of Life of Female Patients with Acromegaly
Kadın Akromegali Hastalarında Psikolojik Focus Grup Terapisinin Hayat Kalitesi Üzerine Etkileri
Received Date : 23 Jul 2020
Accepted Date : 21 Sep 2020
Available Online : 19 Oct 2020
Doi: 10.25179/tjem.2020-78227 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:300-307
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Chronic diseases such as acromegaly affect psychological health. This study aimed to evaluate the effects of a 1- year-long psychological focus group therapy on the quality of life of patients with acromegaly. Material and Methods: Seven female patients with acromegaly, followed-up at the endocrinology outpatient clinic of Cerrahpasa Medical Faculty, were evaluated. The weekly group psychotherapy sessions were conducted by a psychoanalyst and a clinical psychologist between May 2018 and May 2019. Beck Depression Inventory (BDI) and Acromegaly Quality of Life (AcroQoL) scales were assessed at baseline, 3-months, 6-months, and 1-year of group therapy. Results: The mean age of the patients was 43.7 ±6.2years, and the median duration of disease was 8 [3-10] years. Six patients were in disease remission. There was a significant improvement in the BDI (p=0.008) and AcroQoL-total scores (p=0.04) from the beginning till the end of the study. A strong negative correlation was observed between BDI and AcroQoL- 2 (p=0.003; r=-0.91 vs. p=0.04; r=-0.77) and AcroQoLtotal (p=0.03; r=-0.78 vs. p=0.01; r=-0.85) scores at baseline and the 3-months of therapy, respectively. Moreover, the psychoanalyst reported that the patients showed an improved ability to face difficulties caused by their illnesses, expressed their emotional reactions more freely, and were more capable of enduring the disease. Conclusion: Patients with acromegaly benefited from the 1-year psychological focus group therapy in terms of psychological well-being, along with improved AcroQoL and BDI scores. Psychotherapeutic approaches, starting with the diagnosis of the disease, might be a significant intervention that improves the quality of life of patients with acromegaly.
ÖZET
Amaç: Akromegali gibi kronik hastalıklar psikolojik sağlığı etkiler. Bu çalışmanın amacı, akromegali hastalarında 1 yıllık psikolojik focus grup terapisinin hastaların hayat kalitesi üzerine etkisini araştırmaktı. Gereç ve Yöntemler: Cerrahpaşa Tıp Fakültesi endokrinoloji kliniğinde takip edilmekte olan 7 kadın akromegali hastası çalışmaya katıldı. Haftalık grup psikoterapi seansları, Mayıs 2018 ile Mayıs 2019 arasında bir psikanalist ve bir klinik psikolog tarafından gerçekleştirildi. Beck Depresyon Envanteri (BDE) ve Akromegali Hayat Kalitesi Ölçeği (Acro- QoL) terapinin başlangıcında, 3. ve 6. aylarda ve 1. yılda değerlendirildi. Bulgular: Hastaların ortalama yaşı 43,7±6,2 yıl, ve ortanca hastalık süresi 8 [3-10] yıldı. Altı hasta remisyondaydı. Çalışmanın başlangıcından sonuna doğru BDE (p=0,008) ve Acro-QoL-total (p=0,04) skorlarında anlamlı düzelme saptandı. Başlangıç ve 3. ay BDE ile AcroQoL-2 (p=0,003; r=-0,91 vs. p=0,04; r=-0,77) ve BDE ile AcroQoLtotal (p=0,03; r=-0,78 vs. p=0,01; r=-0,85) skorları arasında kuvvetli negatif korelasyon saptandı. Ayrıca, psikanalist, hastaların hastalıklarının neden olduğu zorluklarla yüzleşmede belirgin bir ilerleme gösterdiklerini, duygusal tepkilerini daha özgürce ifade ettiklerini ve hastalıkla daha rahat baş edebildiklerini bildirdi. Sonuç: Akromegali hastalarında 1 yıllık psikolojik focus grup terapisi psikolojik iyilik hâlleri açısından fayda sağlamış olup bu fayda BDE ve Acro-QoL skorlarında iyileşmeye de yol açmıştır. Tanı anından itibaren yapılacak psikoterapötik yaklaşımlar akromegali hastalarının yaşam kalitesini arttıracak önemli bir girişim olabilir.
KAYNAKLAR
  1. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25:102-152. [Crossref]  [PubMed] 
  2. Woodhouse LJ, Mukherjee A, Shalet SM, Ezzat S. The influence of growth hormone status on physical impairments, functional limitations, and health-related quality of life in adults. Endocr Rev. 2006;27:287-317. [Crossref]  [PubMed] 
  3. Ben-Shlomo A, Sheppard MC, Stephens JM, Pulgar S, Melmed S. Clinical, quality of life, and economic value of acromegaly disease control. Pituitary. 2011;14:284-294. [Crossref]  [PubMed]  [PMC] 
  4. Malhotra S, Singh G. Psychological consequences of chronic physical illnesses in children and adolescents. Indian J Pediatr. 2002;69:145-148. [Crossref]  [PubMed] 
  5. Guthrie E. Emotional disorder in chronic illness: psychotherapeutic interventions. Br J Psychiatry. 1996;168:265-273. [Crossref]  [PubMed] 
  6. Kyriakakis N, Lynch J, Gilbey SG, Webb SM, Murray RD. Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: Results from a 5-years prospective study. Clin Endocrinol (Oxf). 2017;86:806-815. [Crossref]  [PubMed] 
  7. Imran SA, Tiemensma J, Kaiser SM, Vallis M, Doucette S, Abidi E, Yip CE, De Tugwell B, Siddiqi F, Clarke DB. Morphometric changes correlate with poor psychological outcomes in patients with acromegaly. Eur J Endocrinol. 2016;174:41-50. [Crossref]  [PubMed] 
  8. Webb SM, Badia X. Quality of life in acromegaly. Neuroendocrinology. 2016;103:106-111. [Crossref]  [PubMed] 
  9. Kunzler LS, Naves LA, Casulari LA. Cognitive-behavioral therapy improves the quality of life of patients with acromegaly. Pituitary. 2018;21:323-333. [Crossref]  [PubMed] 
  10. Kunzler LS, Naves LA, Casulari LA. The effect of cognitive-behavioral therapy on acromegalics after a 9-month follow-up. Front Endocrinol (Lausanne). 2019;10:380. [Crossref]  [PubMed]  [PMC] 
  11. Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Türk Psikoloji Dergisi. 1989;6:3-13. [Link] 
  12. Webb SM. Quality of life in acromegaly. Neuroendocrinology. 2006;83:224-229. [Crossref]  [PubMed] 
  13. Buchanan DC. Group therapy for chronic physically ill patients. Psychosomatics. 1978;19:425-431. [Crossref]  [PubMed] 
  14. Conte HR. Review of research in supportive psychotherapy: an update. Am J Psychother. 1994;48:494-504. [Crossref]  [PubMed] 
  15. Saravay SM. Psychiatric interventions in the medically ill. Outcome and effectiveness research. Psychiatr Clin North Am. 1996;19:467-480. [Crossref]  [PubMed] 
  16. van der Pompe G, Duivenvoorden HJ, Antoni MH, Visser A, Heijnen CJ. Effectiveness of a short-term group psychotherapy program on endocrine and immune function in breast cancer patients: an exploratory study. J Psychosom Res. 1997;42:453-466. [Crossref]  [PubMed] 
  17. Biermasz NR, van Thiel SW, Pereira AM, Hoftijzer HC, van Hemert AM, Smit JW, Romijn JA, Roelfsema F. Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess. J Clin Endocrinol Metab. 2004;89:5369-5376. [Crossref]  [PubMed] 
  18. Mattoo SK, Bhansali AK, Gupta N, Grover S, Malhotra R. Psychosocial morbidity in acromegaly: a study from India. Endocrine. 2008;34:17-22. [Crossref]  [PubMed] 
  19. Webb SM, Crespo I, Santos A, Resmini E, Aulinas A, Valassi E. MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease. Eur J Endocrinol. 2017;177(1):R13-R26. [Crossref]  [PubMed] 
  20. Webb SM, Badia X. Quality of life in growth hormone deficiency and acromegaly. Endocrinol Metab Clin North Am. 2007;36:221-232. [Crossref]  [PubMed] 
  21. Matta MP, Couture E, Cazals L, Vezzosi D, Bennet A, Caron P. Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance. Eur J Endocrinol. 2008;158:305-310. [Crossref]  [PubMed] 
  22. Paisley AN, Rowles SV, Roberts ME, Webb SM, Badia X, Prieto L, Shalet SM, Trainer PJ. Treatment of acromegaly improves quality of life, measured by AcroQol. Clin Endocrinol (Oxf). 2007;67:358-362. [Crossref]  [PubMed] 
  23. Geraedts VJ, Andela CD, Stalla GK, Pereira AM, van Furth WR, Sievers C, Biermasz NR. Predictors of quality of life in acromegaly: no consensus on biochemical parameters. Front Endocrinol (Lausanne). 2017;8:40. [Crossref]  [PubMed]  [PMC] 
  24. Gatto F, Campana C, Cocchiara F, Corica G, Albertelli M, Boschetti M, Zona G, Criminelli D, Giusti M, Ferone D. Current perspectives on the impact of clinical disease and biochemical control on comorbidities and quality of life in acromegaly. Rev Endocr Metab Disord. 2019;20:365-381. [Crossref]  [PubMed] 
  25. Vandeva S, Yaneva M, Natchev E, Elenkova A, Kalinov K, Zacharieva S. Disease control and treatment modalities have impact on quality of life in acromegaly evaluated by Acromegaly Quality of Life (AcroQoL) questionnaire. Endocrine. 2015;49:774-782. [Crossref]  [PubMed] 
  26. Kauppinen-Mäkelin R, Sane T, Sintonen H, Markkanen H, Välimäki MJ, Löyttyniemi E, Niskanen L, Reunanen A, Stenman UH. Quality of life in treated patients with acromegaly. J Clin Endocrinol Metab. 2006;91:3891-3896. [Crossref]  [PubMed] 
  27. Webb SM, Badia X, Surinach NL; Spanish AcroQol Study Group. Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol. 2006;155:269-277. [Crossref]  [PubMed] 
  28. Tiemensma J, Kaptein AA, Pereira AM, Smit JW, Romijn JA, Biermasz NR. Affected illness perceptions and the association with impaired quality of life in patients with long-term remission of acromegaly. J Clin Endocrinol Metab. 2011;96:3550-3558. [Crossref]  [PubMed] 
  29. Johnson MD, Woodburn CJ, Vance ML. Quality of life in patients with a pituitary adenoma. Pituitary. 2003;6:81-87. [Crossref]  [PubMed] 
  30. Webb SM. Pituitary tumors: coping with 'cured' pituitary tumors. Nat Rev Endocrinol. 2011;7:251-252. [Crossref]  [PubMed] 
  31. Tiemensma J, Kaptein AA, Pereira AM, Smit JW, Romijn JA, Biermasz NR. Coping strategies in patients after treatment for functioning or nonfunctioning pituitary adenomas. J Clin Endocrinol Metab. 2011;96:964-971. [Crossref]  [PubMed] 
  32. T'Sjoen G, Bex M, Maiter D, Velkeniers B, Abs R. Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian registry on acromegaly. Eur J Endocrinol. 2007;157:411-417. [Crossref]  [PubMed]