Psychiatry Investig.  2022 Jun;19(6):418-426. 10.30773/pi.2022.0010.

Risk of Mental Illnesses in Patients With Hypopituitarism: A Nationwide Population-Based Cohort Study

Affiliations
  • 1Department of Anatomy, China Medical University, Taichung, Taiwan
  • 2Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
  • 3Department of Psychiatry, China Medical University, Taichung, Taiwan
  • 4Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan

Abstract


Objective
The associations of mental illnesses and hypopituitarism have been reported. But, pituitary disorders are rare. The epidemiological studies have rarely addressed these associations between pituitary disorder and mental illnesses. Until now, no cohort study has been conducted to investigate the association.
Methods
We performed a nationwide, retrospective cohort study using the Taiwanese National Health Insurance Program dataset to analyze this relationship. In total, 1,194 patients diagnosed with hypopituitarism between 2000 and 2013 were identified. For the control group, 4,776 individuals without hypopituitarism and psychotic diseases were matched (1:4) according to age, sex, and index date. A Cox proportional hazards model was used to determine the adjusted hazard ratio (aHR).
Results
Patients with hypopituitarism had a significantly higher risk of incident depression and anxiety disorders than those without hypopituitarism. The aHRs of depressive and anxiety disorders were 2.98 and 1.67, respectively, for the hypopituitarism cohort. Furthermore, the risk of both hypopituitarism-associated depressive and anxiety disorders was significantly high in female subjects and subjects aged ≥18 years. A statistically significant increase was not observed in the risk of bipolar disorders, dementia, or schizophrenia in the hypopituitarism group compared with the control group.
Conclusion
Although psychiatric morbidities were uncommon for the hypopituitarism cohort, the risk of developing depressive and anxiety disorders was significantly higher in those with hypopituitarism than in those without hypopituitarism.

Keyword

Hypopituitarism; Depressive disorder; Anxiety disorder; Age; Sex difference
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