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Psychological distress in patients with hyperprolactinaemia
A Reavley1, A D Fisher, D Owen
1Department of Clinical Endocrinology, Manchester Royal Infirmary, UK.
Clinical Endocrinology
|November 28, 1997
Summary
Women with hyperprolactinaemia (high prolactin levels) experience significant anxiety, especially those without a visible pituitary adenoma. This suggests psychological distress may play a role in functional hyperprolactinaemia.
Area of Science:
- Endocrinology
- Neuroendocrinology
- Psychiatry
Background:
- Hyperprolactinaemia, characterized by elevated prolactin levels, is associated with physical symptoms like galactorrhoea and amenorrhoea.
- Psychological symptoms, including depression, anxiety, and hostility, have also been reported in women with hyperprolactinaemia.
- The distinction between hyperprolactinaemia caused by pituitary adenomas and 'functional' or idiopathic hyperprolactinaemia requires further investigation regarding psychological impact.
Purpose of the Study:
- To assess psychological symptoms in a large cohort of women with hyperprolactinaemia.
- To compare psychological symptom scores between hyperprolactinaemic patients with and without evidence of pituitary adenoma on CT scans.
- To investigate the relationship between pituitary adenoma presence and the severity of psychological distress in hyperprolactinaemia.
Main Methods:
- A population-based, controlled study involving female patients with hyperprolactinaemia.
- Comparison of 65 hyperprolactinaemic women with 26 normoprolactinaemic controls with pituitary disease.
- Assessment of psychological wellbeing using the Hospital Anxiety and Depression (HAD) Scale and the 90-item Symptom Checklist (SCL-90).
Main Results:
- 54% of hyperprolactinaemic patients exhibited definite or borderline anxiety, compared to 27% of controls.
- Women with normal CT scans (idiopathic hyperprolactinaemia) showed significantly higher rates of anxiety (73%) than those with pituitary adenomas (41%).
- While depression scores did not differ, hyperprolactinaemic patients reported higher hostility scores than controls.
Conclusions:
- Confirms significant anxiety in a subset of women with hyperprolactinaemia.
- Women with functional hyperprolactinaemia (normal CT) exhibit greater psychological distress than those with pituitary microadenomas.
- Findings may offer insights into the pathogenesis of functional hyperprolactinaemia.