To evaluate changes in quality of life (QoL), depression, and anxiety in patients with Cushing's syndrome before and after biochemical control, and to identify predictors of clinically meaningful improvement.
Key Findings:
Significant improvements in QoL (+18.2), BDI-II (-6.8), STAI-State (-9.6), and STAI-Trait (-8.6) post-treatment (all P < .001).
Clinically meaningful improvement achieved in 64.6% for QoL, 67.9% for BDI-II, and around 53% for STAI subscales.
Predictors of QoL improvement included lower baseline BMI, shorter duration of symptoms, prolonged hydrocortisone replacement, and normal late-night salivary cortisol.
Depression improvements were linked to shorter symptom duration, normal late-night salivary cortisol, and surgical treatment.
Anxiety improvements were associated with younger age and prolonged hydrocortisone replacement.
Interpretation:
Effective treatment improves mood and QoL in Cushing's syndrome, but recovery is variable and incomplete for some patients, emphasizing the need for comprehensive posttreatment care.
Limitations:
Small sample size and limited follow-up duration.
Potential biases in patient-reported outcomes.
Nonlinear recovery trajectories and recurrence rates complicate assessment.
Conclusion:
While treatment leads to significant improvements in mood and QoL, the variability in recovery highlights the importance of timely diagnosis and ongoing care.
The agency outlined early regulatory actions supporting nonanimal methods, including draft guidance, artificial intelligence tools, and expanded use of human-relevant data models.
