Figure 1.

Psychological burden of acromegaly. Acromegaly inexorably causes body changes and loss of control on the body, resulting in a remarkable psychological impact, as body and mind are strictly interlinked, and many psychological factors (awareness of being ill, poor sleep quality and quality of life, compromised sexuality, and cognitive functions) seem to be crucial in the management of this chronic and debilitating disease. Therefore, acromegaly is associated with increased psychological morbidity. Global psychological health (A) is impaired mainly in the depressive dimension due to the increase in anxious state and discomfort in body image. Sleep quality (B) is also aggravated by increased daily sleepiness, reduced quality of working ability, and limited cognitive functions. Cognitive impairment (C) results in a remarkable reduction of working memory, as well as decreased attention and self-efficacy. In addition, sexual function (D) is compromised in both sexes, mainly because of a mild erectile dysfunction in men, reduced lubrification, and increased pain in women, with orgasm, desire, and satisfaction lowering in both sexes. Overall quality of life (E) is scant, particularly in the physical, body image, and relationship quality domains.