Cognitive-behavioral therapy improves the quality of life of patients with acromegaly

Abstract

Background: The delayed diagnosis, altered body image, and clinical complications associated with acromegaly impair quality of life.

Purpose: To assess the efficacy of the cognitive-behavioral therapy (CBT) technique "Think Healthy" to increase the quality of life of patients with acromegaly.

Methods: This non-randomized clinical trial examined ten patients with acromegaly (nine women and one man; mean age, 55.5 ± 8.4 years) from a convenience sample who received CBT. The intervention included nine weekly group therapy sessions. The quality of life questionnaire the 36-Item Short Form Survey (SF-36) and the Beck Depression Inventory (BDI) were administered during the pre- and post-intervention phases. The Wilcoxon signed-rank test was performed to assess the occurrence of significant differences.

Results: According to the SF-36, the general health domain significantly improved (d' = - 0.264; p = 0.031). The mental health domain improved considerably (d' = - 1.123; p = 0.012). Physical functioning showed a non-significant trend toward improvement (d' = - 0.802; p = 0.078), although four of the five patients who showed floor effects improved and remained at this level. Regarding emotional well-being, five patients showed floor effects and four improved, and the condition did not change among any of the four patients who showed ceiling effects. No significant changes were found with regard to the other domains. No significant differences in the BDI were found before or after the intervention.

Conclusion: The technique presented herein effectively improved the quality of life of patients with acromegaly with different levels of disease activity, type, and treatment time.

Keywords: Acromegaly; Cognitive-behavioral therapy; Depression; Quality of life; SF-36.