Disease Activity is Associated with Depression and Anxiety in Cushing's Syndrome During COVID-19 Pandemic

ABSTRACT

Objective: To assess the depression and anxiety and their relationship with disease activity in patients with Cushing's syndrome (CS) in the coronavirus disease-2019 (COVID-19) pandemic. Material and Methods: This cross-sectional study included 54 patients with CS (48 females, 6 males). Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI)-State, STAI-Trait were used to evaluate scores and severity of depression, the current state of anxiety, and general anxiety, respectively. Patients with active CS (n=10) were recorded as group 1, those who were still receiving glucocorticoid replacement therapy after surgery (n=14) as group 2, and those in remission (n=30) as group 3. The groups were compared in terms of parameters that could affect anxiety and depression scores. Correlation analyses were also performed. Results: BDI-II scores were higher in group 1 than group 3 (p=0.002), and STAI-State scores were higher in group 1 than group 2 (p=0.03) while STAI-Trait scores and the other parameters were similar between the groups. Moderate and severe depression were detected in 60% of group 1, 25% of group 2, and 16% of group 3 patients. High state anxiety was seen in 70% of patients in group 1, 50% of group 2, and 57% of group 3 patients. Positive correlations between BDI-II scores and disease activity (r=0.438, p=0.001) and STAI-State scores and disease activity (r=0.297, p=0.029) were observed. Conclusion: Increased depression and state anxiety during the pandemic in patients with active CS suggests that psychiatric disorders may increase in those with a higher risk of severe COVID-19 disease.