SAT-086 Increased Risk for Psychiatric Comorbidity, but not Dementia, in Acromegaly - a Nationwide Register-Based Cohort Study with Matched Controls

Abstract Disclosure: J. Robèrt: None. E. Tsatsaris: None. K. Berinder: None. L. Bonelli: None. P. Burman: None. P. Dahlqvist: None. C. Hoybye: None. O. Ragnarsson: None. K. Vouzouneraki: None. A. Åkerman: None. B. Eden Engström: None. B. Ekman: None. The quality of life in patients with acromegaly is affected by psychological, social and cognitive impairment, but there are few studies on actual psychiatric and cognitive disease comorbidity. In this study, we aimed to evaluate the incidence of psychiatric and neurocognitive disease in Swedish acromegaly patients compared to controls from the general population. All patients (n= 1035) with acromegaly diagnosed in Sweden between 1991-2018 were identified through two national registries, the National Patient Register (NPR) and Swedish Pituitary Register (SPR). The diagnosis was validated by reviewing medical records if recorded in only one of the registers. Ten controls per patient (n=10 261), matched for age, sex and place of residence, were included. The mean age at acromegaly diagnosis was 52 years (Q1-Q3: 40 - 62), 50.5 % were male, surgical resection was performed in 831 (80.3 %) patients. Depression was the most common comorbidity and was evaluated with composite outcomes comprised of diagnostic codes for depression (1991-2018) and prescriptions for anti-depressant drugs (2005-2018) recorded in the registries. The risk of depression was higher in patients with acromegaly after diagnosis (HR adjusted Cox proportional hazards model 1.84, 95 % CI 1.46-2.31, p < 0.001) than in the controls. Disease status, surgical treatment, radiotherapy, or pituitary insufficiency did not influence the risk. During the five years prior to acromegaly diagnosis, there was a trend towards higher risk of depression in the acromegaly cohort (HR unadjusted model 1.4, 0.99 - 1.98, p = 0.055), but the number of events were few. The hazard for anxiety syndromes, substance- or alcohol abuse syndrome, or death by suicide, was not significantly increased. Prescriptions for anxiolytics (HR adj 1.55, 1.22 - 1.97, p < 0.001) and hypnotics (HR adj 1.74, 1.38 - 2.20, p<0.001) were more common in the acromegaly group. Hypnotics were more frequently prescribed to acromegaly patients during the five years preceding diagnosis (HR adj 1.58, 1.13 - 2.21, p = 0.007). All cause dementia, as defined by a composite outcome comprised of diagnostic code for all types of dementia and prescriptions for choline esterase inhibitors or memantine, was equally common in both groups (HR adj 0.99, 0.65 - 1.53, p = 0.98). These results underline the need for screening of psychiatric comorbidities, particularly depression, in patients with acromegaly. Whether the increased hazard is due to psychosocial reasons surrounding the diagnosis or the biological effect of the GH-/IGF-system remains unclear. Presentation: Saturday, July 12, 2025