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Psychological Burden in Mild Autonomous Cortisol Secretion: A Cross-Sectional Comparative Study.

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Mild autonomous cortisol secretion (MACS) patients report mild depressive and anxiety symptoms but have significantly impaired quality of life compared to population norms. Psychological screening is recommended for MACS evaluation.

Keywords:
Adrenal incidentalomaAnxietyDepressionMild autonomous cortisol secretionQuality of lifeSubclinical hypercortisolism

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Area of Science:

  • Endocrinology
  • Psychology
  • Quality of Life Research

Background:

  • Mild autonomous cortisol secretion (MACS) involves cortisol excess without overt Cushing's syndrome.
  • Metabolic complications of MACS are known, but the psychological impact is less understood.
  • Assessing psychological burden and quality of life in MACS patients is crucial.

Purpose of the Study:

  • To evaluate self-reported depressive and anxiety symptoms in MACS patients.
  • To assess health-related quality of life in MACS patients using validated Turkish instruments.
  • To compare these findings with Turkish population norms.

Main Methods:

  • A cross-sectional study of 40 MACS patients diagnosed per European Society of Endocrinology guidelines.
  • Psychological assessments included Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).
  • Health-related quality of life was measured using the Short Form-36 (SF-36) Turkish version.

Main Results:

  • MACS patients reported minimal to mild depressive (BDI: 1.93±0.80) and mild anxiety symptoms (BAI: 2.30±0.82).
  • SF-36 scores were significantly lower than Turkish norms across most domains (p < 0.001), excluding emotional well-being.
  • No significant psychological differences were found based on post-dexamethasone cortisol levels.

Conclusions:

  • MACS patients experience impaired quality of life despite mild psychological symptoms.
  • Findings suggest the value of psychological screening and quality of life assessments in MACS.
  • Limitations include the lack of a matched control group and potential confounding factors.