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

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.