ESPE Abstracts

Introduction: Hypopituitarism has been reported to be associated with lower quality of life (QoL), marital rates, and sex-life satisfaction in adulthood in patients with GH deficiency. Very few studies have examined this in those with childhood-onset multiple pituitary hormone deficiency (COMPHD).

Aims: To evaluate QoL in adults with COMPHD.

Subjects and methods: All COMPHD patients aged (≥18 years were identified from medical records and clinics of one author (m zacharin). Questionnaires were mailed to all potential participants who expressed interest. The World Health Organization QoL Questionnaire, Kessler psychological distress scale, Female Sexual Function Index (FSFI) and Male Sexual Quotient (MQ19) were used to measure QoL, psychological distress, female and male psychosexual function respectively. Age- and sex-matched controls were recruited for every patient.

Results: 92 (68.1%) of 135 potential patients participated, 6 (4.4%) refused, and 37 (27.4%) did not respond. 51 (55%) male, 41 (45%) females, mean age 29.7 years (S.D. 8.18; range 18–61) completed the questionnaire. Mean age at diagnosis was 6.7±4.9 years. COMPHD was caused by brain tumour in 63 (68.5%), congenital hypopituitarism 19 (20.1%), other cancers 7 (7.6%) and trauma 3 (3.3%). COMPHD patients were shorter, more overweight, experienced more behaviour problems in childhood, had significantly less education, more unemployment, lower income and marital rates and less children, compared to healthy controls (P<0.005 for each). Although they scored significantly lower in all QoL domains (P≤0.001) and psychosexual function (FSFI, P<0.001 and MQ19 P=0.004), there was no difference in reported psychological distress (P=0.119). Subgroup analysis of non-cancer patients showed significantly lower educational achievement (P=0.014) and more behaviour problems in childhood (P<0.001) than controls. There was a non-significant trend for lower QoL and psychosexual function scores in the cancer group.

Conclusion: Adults with COMPHD have significantly lower QoL compared to normal peers. In addition to medical care of endocrine deficiencies, difficulties in psychosocial and psychosexual function need to be addressed.