Decreased psychological well-being in adult patients with growth hormone deficiency

OBJECTIVE: Besides effects on body composition, bone mineral content and lipid metabolism, GH seems to influence quality of life, according to previous studies of limited numbers of patients with GH deficiency of childhood and adult origin. In this study psychological well-being was assessed in a large number of patients with GH deficiency of adult origin.

DESIGN: A follow-up study of patients with hypopituitarism on routine replacement therapy with L-thyroxine, cortisone acetate and sex steroids.

PATIENTS: Eighty-six patients (51 men, mean age 55.4 years and 35 women, mean age 54.9 years) diagnosed as having growth hormone deficiency on the basis of low IGF-I concentration or a maximum GH response less than 5 mU/l after an insulin/glucagon tolerance test.

MEASUREMENTS: Quality of life was measured with a self-rating questionnaire, the Nottingham Health Profile, and the results were compared with the results from 86 controls matched for age, gender, marital status and socioeconomic class. Furthermore, the observed and expected number of disablement pensions were calculated.

RESULTS: The mean total score of the patients was higher, i.e. worse (P < 0.05), than that of the matching controls, indicating a higher level of perceived health problems among the patients. There were higher scores (poorer life quality) for energy (P < 0.001), social isolation (P < 0.01), emotional reaction (P = 0.056) and sex life (P < 0.001) among patients compared with controls. Finally, the observed number of disablement pension among the patients tended to be higher than expected (19 vs 12.4, P = 0.09).

CONCLUSIONS: Adult patients with GH deficiency have a decreased psychological well-being in terms of energy, social isolation and emotional reaction and a disturbed sex life compared with normals. Furthermore, there is a tendency to a higher frequency of early retirement.