Tuesday, January 11, 2011

Coping Strategies in Patients after Treatment for Functioning or Nonfunctioning Pituitary Adenomas

The Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2010-2490

Jitske Tiemensma*, Adrian A. Kaptein, Alberto M. Pereira, Johannes W. A. Smit, Johannes A. Romijn, and Nienke R. Biermasz
Departments of Endocrinology and Metabolism (J.T., A.M.P., J.W.A.S., J.A.R., N.R.B.) and Medical Psychology (A.A.K.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands
* To whom correspondence should be addressed. E-mail: J.Tiemensma@lumc.nl.

Context and Objective: Coping strategies may affect quality of life, which is decreased in patients after treatment for Cushing's disease, acromegaly, or nonfunctioning pituitary macroadenomas (NFMA). We aimed to explore coping strategies in these patients because this has never been done before.

Design: We conducted a cross-sectional study.

Subjects: We included patients treated for Cushing's disease (n = 42), for acromegaly (n = 80), and for NFMA (n = 61). These patients were compared with three reference populations: an a-select sample from the Dutch population (n = 712), patients with chronic pain (n = 59), and patients receiving primary care psychology services (n = 525). Furthermore, the three patient groups were compared with each other. Coping strategies were assessed by the Utrecht Coping List.

Results: Compared with the a-select sample, patients with pituitary adenomas reported less active coping (P < 0.0001), sought less social support (P < 0.0001), and reported more avoidant coping (P = 0.008). In contrast, patients treated for pituitary adenomas reported somewhat better coping strategies than patients with chronic pain and those with psychological disease. When patients with different pituitary adenomas were compared, patients treated for Cushing's disease sought more social support than patients treated for NFMA (P = 0.035).

Conclusions: Patients treated for pituitary adenomas display different and less effective coping strategies compared with healthy controls. A targeted intervention might help to stimulate patients to use a more active coping strategy and to seek social support instead of an avoiding coping strategy. This might, in turn, improve their quality of life.

From http://jcem.endojournals.org/cgi/content/abstract/jc.2010-2490v1