Recent progress in the understanding of psychological complications of acromegaly: toward a longitudinal clinical phenotype.

Acromegaly is a chronic endocrine disorder where biochemical remission often fails to ensure psychological recovery. Drawing on cross‑sectional, longitudinal and registry evidence, this paper proposes a longitudinal clinical phenotype to reconcile divergence between hormonal control and patient‑reported outcomes. Psychological burden unfolds along a temporal gradient, where HR‑QoL captures persistent functional and somatic sequelae, emotional distress reflects adaptive strain during disease transitions, and psychiatric morbidity emerges from cumulative dysfunction. Treatment burden, chronic pain/arthropathy and subtle cognitive deficits are highlighted as mediators that sustain or worsen psychological outcomes. This framework supports routine longitudinal psychological assessment and integrated management of residual structural burden and psychosocial adaptation to improve lived recovery.