Prospective Assessment of Mood and Quality of Life in Cushing Syndrome Before and After Biochemical Control
Authors' conclusion
Although effective treatment improves mood and QoL in CS, clinically meaningful recovery is variable and incomplete for some patients. Our findings highlight the need to limit diagnostic delay and provide comprehensive posttreatment care that includes normalization of cortisol circadian rhythm.
Study context
- Population
- Patients with endogenous cushing's syndrome (CS) (60 pituitary, 7 adrenal), assessed with active disease and after biochemical control by surgery and/or medication; tertiary center
- Participants
- 67 patients
- Exposure
- Active disease vs after biochemical control
- Outcome
- Changes in QoL (CushingQoL), depression (BDI-II) and anxiety (STAI)
- Follow-up
- Mean 2.3 years
Methodological detailssingle tertiary center, before-after, Mean follow-up 2.3 years; longest 11.5 years
- Single tertiary center
- Before-after
- Mean follow-up 2.3 years; longest 11.5 years
Main finding
As reported in the abstract
Change in mean scores after treatment
- Quality of life (QoL) change (mean ± SD)
- +18.2 ± 20.9
- Beck Depression Inventory-II (BDI-II) change (mean ± SD)
- −6.8 ± 8.6
- STAI-State change (mean ± SD)
- −9.6 ± 12.5
- STAI-Trait change (mean ± SD)
- −8.6 ± 12.6
- P, all domains
- P < .001
Observational data: associations, not effects.
Further findings
Minimal important difference achieved
- QoL
- 64.6%
- BDI-II
- 67.9%
- State-Trait Anxiety Inventory (STAI) subscales
- 53.2% and 52.8%
Predictors of improvement (multivariable analysis)
- QoL: lower baseline BMI, pretreatment symptoms <3 years, postoperative hydrocortisone replacement >6 months, normal follow-up late-night salivary cortisol
- Depression: symptoms <3 years, normal follow-up late-night salivary cortisol, surgical treatment
- Anxiety: younger age, >6 months postoperative hydrocortisone
- Depression improved more gradually than QoL and anxiety
Original publication
Prospective Assessment of Mood and Quality of Life in Cushing Syndrome Before and After Biochemical Control. J Clin Endocrinol Metab. Published 31 October 2025. doi:10.
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