Endocrine Abstracts

JOINT2738

Importance: Current research has yet to elucidate the potential relationship between non-functional adrenal tumors (NFATs) and various mental health conditions, including psychiatric and sleep-related disorders. An increase could be hypothesized due to very mildly abnormal cortisol secretion in patients with NFATs.

Objective: To investigate the prevalence and incidence of psychiatric and sleep-related disorders in individuals diagnosed with NFAT.

Design, setting, and participants: A national retrospective register-based study was conducted on patients diagnosed with NFAT in Sweden from 2005 to 2019 and controls without adrenal tumor diagnosis, followed until death or the conclusion of 2020. Individuals diagnosed with adrenal hormonal excess were excluded from the study.

Exposures: NFAT diagnosis.

Main outcomes and measures: Primary study outcomes were the prevalence and incidence of any psychiatric and sleep disorders after adjustment for sex and age. The secondary outcomes were sleep disorders, substance abuse disorders, psychotic disorders, mood disorders, anxiety and stress-related disorders.

Results: Among 33 348 cases, 18 510 (55.5%) were women, and the median (IQR) age was 68 (59; 74) years. Among 144 983 controls, 80 942 (55.8%) were women, and the median (IQR) age was 67 (59; 74) years. Previous psychiatric and sleep disorders were more prevalent in patients diagnosed with NFAT compared to controls (odds ratio (OR) 1.74, 95% CI 1.69–1.80, adjusted OR 1.71, 95% CI 1.66–1.77). Similar increases were found in all secondary outcomes. During the follow-up period (5.4 years (IQR 2.5–8.8)), the incidence of psychiatric and sleep disorders was higher in patients with NFAT than in controls (hazard ratio (HR) 2.06, 95% CI 1.97–2.15, adjusted HR 2.03, 95% CI 1.94–2.13). Similar increases were found in all secondary outcomes.

Conclusion and relevance: NFAT was associated with an increased risk of psychiatric and sleep disorders.