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Santos A, Nalin C, Bortolotti G, Dominguez-Clave E, Daniela G, Cortesi L, Pagani M, Momblan MAM, Gich I, Webb SM, Trevisan R, Resmini E. The effect of mindfulness therapy in acromegaly, a pilot study. Clin Endocrinol (Oxf) 2023; 98:363-374. [PMID: 36342059 DOI: 10.1111/cen.14844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients with acromegaly have often several comorbidities, including decreased quality of life, mood alterations and chronic pain. Mindfulness is effective at improving mood, quality of life and pain management; however, there is no data available on its effect in patients with acromegaly. OBJECTIVE We aimed at evaluating changes in quality of life, mood, pain, sleep, self-compassion, life satisfaction, blood pressure and heart rate after a mindfulness program. DESIGN AND PATIENTS This was a randomized, multicentre, international clinical trial (Barcelona-BCN and Bergamo-BG) of 60 patients, 30 per centre. MEASUREMENTS The intervention group participated in an 8-week face-to-face group program; the control group followed normal clinical routine. In BG, patients performed a classic Mindfulness Based Stress Reduction program; in BCN they performed an adapted program including elements of mindfulness and compassion with a greater focus on daily life. RESULTS In the BCN intervention group there was an increase in night-time hours in bed (p = 0.05) after the program. In both centres there was a trend to a reduction of the time to start sleeping (p = 0.06 BCN, p = 0.07 BG). In BCN, the intervention group reduced the pain score compared to the control group (p = .02), and an improvement in self-compassion was found (p = .04). In both centres, heart rate decreased significantly in the intervention group during a single 2-hour session. This was evidenced at the first and the last program session (BCN p = .013 and p = .009; BG < 0.001 and p = .04). A training effect was found in BG, where heart rate fell more in the last session than in the first (p = 002). CONCLUSIONS We have demonstrated for the first time the value of a mindfulness program in patients with acromegaly, analysing possible effects and advantages, and clarifying the usefulness of a specific protocol for the disease.
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Affiliation(s)
- Alicia Santos
- Endocrinology Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unit747), ISCIII, Hospital Sant Pau, Barcelona, Spain
- Department of Medicine, IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Chiara Nalin
- Meditation and Mindfulness Teacher, Venezia, Italy
| | | | - Elisabet Dominguez-Clave
- Psychiatry Department, Hospital Sant Pau, Barcelona, Spain
- Department of Pharmacology and Therapeutics, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Gianola Daniela
- Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Liana Cortesi
- Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Marina Pagani
- Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Maria A M Momblan
- Department of Fundamental and Medical-Surgical Nursing, Faculty of Medicine and Health Sciences, School of Nursing, L'Hospitalet de Llobregat, University of Barcelona (UB), Barcelona, Spain
| | - Ignasi Gich
- Department Clinical Epidemiology, Hospital Sant Pau, Barcelona, Spain
| | - Susan M Webb
- Endocrinology Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unit747), ISCIII, Hospital Sant Pau, Barcelona, Spain
- Department of Medicine, IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Roberto Trevisan
- Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Eugenia Resmini
- Endocrinology Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unit747), ISCIII, Hospital Sant Pau, Barcelona, Spain
- Department of Medicine, IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Crespo I, Santos A, Valassi E, Pires P, Webb SM, Resmini E. Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly. Endocrine 2015; 50:756-63. [PMID: 26018738 DOI: 10.1007/s12020-015-0634-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/14/2015] [Indexed: 11/25/2022]
Abstract
Evaluation of cognitive function in acromegaly has revealed contradictory findings; some studies report normal cognition in patients with long-term cured acromegaly, while others show attention and memory deficits. Moreover, the presence of affective disorders in these patients is common. Our aim was to evaluate memory and decision making in acromegalic patients and explore their relationship with affective disorders like anxiety and depressive symptoms. Thirty-one patients with acromegaly (mean age 49.5 ± 8.5 years, 14 females and 17 males) and thirty-one healthy controls participated in this study. The Iowa Gambling Task (IGT), Rey Auditory Verbal Learning Test, State-Trait Anxiety Inventory, and Beck Depression Inventory-II (BDI-II) were used to evaluate decision making, verbal memory, anxiety, and depressive symptoms, respectively. Acromegalic patients showed impairments in delayed verbal memory (p < 0.05) and more anxiety and depressive symptoms (p < 0.05) than controls. In the IGT, acromegalic patients presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (p < 0.05) and higher number of the riskier cards (p < 0.05). Moreover, multiple correlations between anxiety and depressive symptoms and performance in memory and decision making were found. Impaired delayed memory and decision making observed in acromegalic patients are related to anxiety and depressive symptoms. Providing emotional support to the patients could improve their cognitive function. A key clinical application of this research is the finding that depressive symptoms and anxiety are essentially modifiable factors.
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Affiliation(s)
- Iris Crespo
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Alicia Santos
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Elena Valassi
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Patricia Pires
- INNDACYT, CR Laureà Miró, 107, Sant Feliu de Llobregat, Barcelona, Spain
| | - Susan M Webb
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eugenia Resmini
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
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Andela CD, Niemeijer ND, Scharloo M, Tiemensma J, Kanagasabapathy S, Pereira AM, Kamminga NGA, Kaptein AA, Biermasz NR. Towards a better quality of life (QoL) for patients with pituitary diseases: results from a focus group study exploring QoL. Pituitary 2015; 18:86-100. [PMID: 24682940 DOI: 10.1007/s11102-014-0561-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Patients treated for pituitary adenomas generally report a reduced quality of life (QoL). At present, the patient's perspective of QoL has not been fully addressed and this, and further insight in potential determinants of QoL in pituitary diseases is required to design strategies to improve QoL. We aimed to define patients' perceived QoL and to identify potential factors they perceive to contribute to QoL. METHODS We conducted four independent focus groups of six patients each, per specific pituitary disease (Cushing's disease, Non-functioning pituitary macroadenoma, acromegaly, prolactinoma). In two sessions these focus groups discussed aspects of QoL. Verbatim transcripts were analyzed using a grounded theory approach. RESULTS The issues raised by the patient groups were compatible with statements and items of available QoL questionnaires. In addition, other QoL aspects emerged, such as visual limitations (physical problems); issues with a desire to have children/family planning, fear of collapsing, fear of recurrence, panic, persisting thoughts, problems with an altered personality, anger, jealousy, sadness, frustration (psychological problems); and difficulties communicating about the disease, lack of sympathy and understanding by others, and a reduced social network (social problems). Next, this study uncovered factors which might contribute to a decreased QoL (e.g. less effective coping strategies, negative illness perceptions, negative beliefs about medicines, unmet needs regarding care). CONCLUSIONS This focus group study demonstrated that important disease-specific aspects of QoL are neglected in current pituitary disease-specific questionnaires and elucidated potential factors that contribute to a decreased QoL. Information provided in this study can (and will) be used for developing additional items for disease-specific QoL questionnaires and for the development of a self-management intervention aiming to improve QoL in patients treated for pituitary diseases.
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Affiliation(s)
- Cornelie D Andela
- Department of Endocrinology and Metabolic Diseases and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, The Netherlands,
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