Body self-image disturbances in women with prolactinoma

Objective: To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma. Methods: Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients' dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms. Results: The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients. Conclusion: Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.

Hiperprolactinemia y disfunción sexual en el primer episodio psicótico tratado con risperidona / Hiperprolactinaemia and sexual disfunction in first psychotic episode treated with risperidone

Hyperprolactinemia and Sexual dysfunction are frequent, yet seldom studied, complications of the use of risperidone Objectives: To determine the prevalence and clinical correlates of sexual dysfunctions and hyperprolactinemia in a sample of young people with schizophrenia treated with risperidone. Methods: 40 outpatients (19 females; mean age: 27 years) with schizophrenia treated with risperidone, participated in the study Sexual dysfunction and quality of life were assessed with the Massachusetts General Hospital Sexual Functioning Questionnaire (MGH-SFQ) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), respectively All patients were evaluated with the Positive and Negative Syndrome Scale and the UKU side effect rating scale. Blood samples were analyzed for prolactine. Results: Hyperprolactinemia was found in 90 percent of patients, with levels significantly higher in women. Sexual dysfunctions occurred in 25 (62.5 percent) patients. Patients with and without sexual dysfunction, did not significantly differ in gender, age or years of treatment. Although no association was found with prolactinemia or the dose of risperidone, patients with sexual dysfunction reported more psychic and neurologic side effects, and had higher scores in the negative symptoms and general psychopatology subscales of the PANSS and lower scores in the physical health and mood items of the Q-LES-Q. Conclusions: Results confirm the high prevalence of hyperprolactinemia and sexual dysfunctions in people with schizophrenia. Further study is warranted in order to clarify the association between sexual dysfunction and risperidone treatment in clinical practice and its impact in the quality of life of the patients.

La hiperprolactinemia y las disfunciones sexuales son complicaciones frecuentes, pero poco estudiadas del tratamiento con risperidona. Objetivos: Determinar la prevalencia de hiperprolactinemia y disfunciones sexuales en un grupo de personas jóvenes con esquizofrenia, tratadas con risperidona. Métodos: Un total de 40 pacientes (19 mujeres, edad promedio: 27 años) completaron el Cuestionario de Funcionamiento Sexual del Hospital General de Massachussets y el Cuestionario sobre Calidad de Vida: Satisfacción y Placer. Todos los pacientes fueron evaluados con las escalas PANSS y UKU y se determinó su nivel plasmático de prolactina. Resultados: El 90 por ciento de los pacientes presenta hiperprolactinemia, con valores significativamente más altos para las mujeres. El 62,5 por ciento de los pacientes, informó padecer alguna disfunción sexual, sin diferencias con la contraparte no afectada, en cuanto a género, edad ni tiempo de tratamiento. Aunque no se encontró relación con la prolactinemia, ni con la dosis de risperidona, quienes reportaron alguna disfunción sexual obtuvieron mayores puntajes de efectos adversos psíquicos y neurológicos en la escala UKU. Las disfunciones sexuales se asociaron con los síntomas negativos y generales de la PANSS y con menores puntajes en las subescalas de salud física y ánimo del Cuestionario sobre Calidad de Vida: Satisfacción y Placer. Conclusiones: Los resultados confirman la elevada frecuencia de disfunciones sexuales e hiperprolactinemia en las personas enfermas de esquizofrenia. Nuevos estudios se requieren para clarificar, en la práctica clínica habitual, la asociación entre disfunción sexual y el empleo de la risperidona, y su impacto en la calidad de vida de los pacientes.

Estados hiperprolactinêmicos: inter-relações com o psiquismo / Hyperprolactinemic conditions: relationships with psychiatric disorders

A hiperprolactinemia é o distúrbio endócrino mais freqüente do eixo hipotálamo-hipofisário, observado em mulheres na idade reprodutiva. Caracteriza-se pela elevação consistente dos valores plasmáticos de prolactina. A regulação da produção da prolactina dá-se por meio da ação inibitória de um neurotransmissor, a dopamina. As manifestações clínicas são distúrbios do ciclo menstrual, amenorréia, galactorréia, infertilidade e diminuição da libido. Entretanto, sintomas psicológicos, especialmente ansiedade e depressão, têm sido associados à hiperprolactinemia. Contudo, há poucos estudos clínicos publicados sobre o tema. O papel da prolactina na patogênese dos distúrbios psiquiátricos pode refletir ação direta sobre o sistema nervoso central, efeito indireto por meio dos hormônios gonadais ou constituir fatores independentes, resultantes da depleção de dopamina. Assim, detectada a prevalência de distúrbios psiquiátricos em pacientes com hiperprolactinemia, conclui-se pela necessidade de maior número de pesquisas que investiguem as bases da possível inter-relação entre os estados hiperprolactinêmicos e o psiquismo.

Hyperprolactinemia is the most frequent endocrine disorder of the hypothalamus-hypophysis axis observed in women of reproductive age. It is characterized by elevated serum prolactin levels. Prolactin production is regulated by the inhibitory action of a neurotransmitter, dopamine. Clinical manifestations include irregular menstrual cycle, amenorrhea, galactorrhea, infertility and libido decrease, but psychological symptoms, especially anxiety and depression, have also been associated with hyperprolactinemia. Nonetheless, few studies about this condition are available. In the pathogenesis of psychiatric disorders, prolactin may have either a direct action on the central nerve system or an indirect effect via gonadal hormones or function as independent factors as a result of dopamine depletion. Thus, since the prevalence of psychiatric disorders in patients with hyperprolactinemia was detected, it was concluded that further studies are necessary to investigate the basis of a potential relationship between both hyperprolactinemic and psychiatric conditions.

Hiperprolactinemia e distúrbios psiquiátricos / Hyperprolactinemia and psychiatric disturbance

Sintomas psicológicos, especialmente ansiedade e depressao, têm sido associados à hiperprolactinemia. Para avaliar a presença desses sintomas, foram submetidos à entrevista através do Composed International Diagnostic Interview, seguido pela escala de Hamilton para depressao, 32 pacientes (5 homens e 27 mulheres) com hiperprolactinemia de várias etiologias e 16 normoprolactinêmicos. A prolactina sérica na época da avaliaçao variou de 28 a 180 ng/mL, sendo que 11 dos pacientes usavam bromocriptina. Detectou-se presença atual de distúrbios de ansiedade em 18 pacientes (56,2 por cento) e 5 controles (31,2 por cento), depressao em 10 pacientes (31,2 por cento) e 2 controles (12,5 por cento), distmia em duas pacientes e outros diagnósticos psiquiátricos em 6 pacientes (18,7 por cento). Os escores da depressao variaram entre 16 e 31 nos pacientes e foram 12 e 16 nos controles. A frequência de sintomas psiquiátricos como um todo, foi significativamente maior nos hiperprolactinêmicos (teste do qui-quadrado), mas a diferença nao foi significativa na análise isolada de ansiedade ou depressao. A hiperprolactinemia representa um fator de risco de 3,57 para depressao, 3,32 para ansiedade e 3,84 para outros sintomas psiquiátricos. Nao houve diferença significativa na frequência de sintomas psiquiátricos entre portadores ou nao de adenomas hipofisários e usuários ou nao de bromocriptina. Nao houve correlaçao (r= 0,07) entre a prolactina e a frequência de sintomas psiquiátricos. Conclui-se pela necessidade de atentar para a concomitância de hiperprolactinemia e distúrbios psiquiátricos, cujo reconhecimento permitirá abordagem terapêutica específica