The Journal of clinical endocrinology and metabolism · 2026
Psychiatric and Sleep Disorders in Patients With Nonfunctional Adrenal Tumors.
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Mirzaei Hadis, Lindh Jonatan D, Mannheimer Buster, Falhammar Henrik
Аннотация
CONTEXT: An increase of psychiatric and sleep-related disorders could be hypothesized due to mild abnormal cortisol secretion in patients with nonfunctional adrenal tumors (NFATs).
OBJECTIVE: To investigate the risk of psychiatric and sleep disorders in individuals with NFATs.
METHODS: A national retrospective register-based study was conducted on patients diagnosed with NFATs 2005-2019 and controls, followed until death or 2019. Individuals diagnosed with adrenal hormone excess or previous malignancies were excluded. Follow-up commenced after 90 days of cancer-free survival following the NFAT diagnosis. Sensitivity analyses were performed on patients with acute appendicitis and gallbladder/biliary tract/pancreas disorders, and 180- and 365-day cancer-free survival. The primary study outcomes were the prevalence and incidence of psychiatric and/or sleep disorders after adjusting for sex, age, and socioeconomic factors. Secondary outcomes were psychiatric, sleep, substance abuse, mood, anxiety and stress-related, and psychotic disorders.
RESULTS: In total, 17 561 cases (60% women, median [IQR] age 65 [56-73] years) and 122 561 controls were included. Previous psychiatric and/or sleep disorders were more prevalent in patients diagnosed with NFATs compared to controls (odds ratio [OR] 2.11; 95% CI 2.03-2.19; adjusted OR 2.06, 95% CI 1.98-2.14). During the follow-up period (5.4 years [IQR 2.4-8.6]), the incidence of psychiatric and/or sleep disorders was higher in patients with NFATs than in controls (hazard ratio [HR] 1.92; 95% CI 1.83-2.02; adjusted HR 1.92; 95% CI 1.82-2.01). Similar increases were found in all secondary outcomes as well as in the same direction in all sensitivity analyses.
CONCLUSION: NFAT was associated with an increased risk of psychiatric and sleep disorders.
OBJECTIVE: To investigate the risk of psychiatric and sleep disorders in individuals with NFATs.
METHODS: A national retrospective register-based study was conducted on patients diagnosed with NFATs 2005-2019 and controls, followed until death or 2019. Individuals diagnosed with adrenal hormone excess or previous malignancies were excluded. Follow-up commenced after 90 days of cancer-free survival following the NFAT diagnosis. Sensitivity analyses were performed on patients with acute appendicitis and gallbladder/biliary tract/pancreas disorders, and 180- and 365-day cancer-free survival. The primary study outcomes were the prevalence and incidence of psychiatric and/or sleep disorders after adjusting for sex, age, and socioeconomic factors. Secondary outcomes were psychiatric, sleep, substance abuse, mood, anxiety and stress-related, and psychotic disorders.
RESULTS: In total, 17 561 cases (60% women, median [IQR] age 65 [56-73] years) and 122 561 controls were included. Previous psychiatric and/or sleep disorders were more prevalent in patients diagnosed with NFATs compared to controls (odds ratio [OR] 2.11; 95% CI 2.03-2.19; adjusted OR 2.06, 95% CI 1.98-2.14). During the follow-up period (5.4 years [IQR 2.4-8.6]), the incidence of psychiatric and/or sleep disorders was higher in patients with NFATs than in controls (hazard ratio [HR] 1.92; 95% CI 1.83-2.02; adjusted HR 1.92; 95% CI 1.82-2.01). Similar increases were found in all secondary outcomes as well as in the same direction in all sensitivity analyses.
CONCLUSION: NFAT was associated with an increased risk of psychiatric and sleep disorders.