Association of self-stigma, impulsivity, and insomnia with anxiety and depression in patients with Kallmann syndrome.

OBJECTIVES

Kallmann syndrome (KS) is a rare inherited disorder characterized by congenital hypogonadotropic hypogonadism and reduced or absent olfactory function. In addition to gonadal dysgenesis and structural abnormalities, KS patients may present with extensive psychosocial dysfunction and behavioral changes. This study aims to evaluate the effects of self-stigma, impulsivity, and insomnia on anxiety and depression in KS patients and to explore the interrelationships among these factors.

METHODS

A total of 206 patients with confirmed KS were recruited from the Xiangya Hospital and Henan Provincial People's Hospital. Multivariable Logistic regression analysis was used to identify independent factors associated with anxiety and depression, and a serial multiple-mediator model was applied to characterize pathway effects.

RESULTS

The cohort of KS patients demonstrated substantial psychological and social burden, including self-stigma, impulsivity, insomnia, loneliness, anxiety, depression, and overall social isolation tendencies. Logistic regression analysis indicated that self-stigma (OR=1.112, P=0.003), loneliness (OR=1.198, P=0.007), and insomnia (OR=1.098, P=0.017) were independent factors the presence of anxiety and depression in KS patients. Mediation-effect modeling further showed that impulsivity and insomnia significantly mediated the effect of self-stigma on anxiety and depression in KS (indirect effect 3=0.013, P=0.008; 95% CI 0.004 to 0.024; c'=0.147, P<0.001; 95% CI 0.091 to 0.201).

CONCLUSIONS

This study preliminarily identified the major modifiable factors associated with anxiety and depression in KS patients, including self-stigma, loneliness, and insomnia. Impulsivity and insomnia demonstrated significant serial mediation effects linking self-stigma to affective outcomes. Multidimensional intervention strategies targeting stigma reduction, impulsivity regulation, and sleep-quality improvement may help alleviate anxiety-depression symptoms and ultimately improve overall quality of life in patients with KS.