Quality of life in Klinefelter patients on testosterone replacement therapy compared to healthy controls: an observational study on the impact of psychological distress, personality traits, and coping strategies

J Endocrinol Invest. 2021 May;44(5):1053-1063. doi: 10.1007/s40618-020-01400-8. Epub 2020 Aug 31.

Abstract

Purpose: We aimed to verify if 1 year-testosterone-replacement therapy could produce a psychopathological recovery and a satisfactory quality of life in Klinefelter syndrome (KS) patients compared to matched healthy controls. Further, we analyzed personality traits and coping strategies, an issue not yet examined in androgen-treated KS patients. We also enquired whether any of the sociodemographic and psychological variables might predict a patient's general and sexual life satisfaction.

Methods: The Quality of Life Enjoyment and Satisfaction Questionnaire and the Temperament and Character Inventory-Revised were administered to both 23 KS patients and matched healthy subjects. Psychopathology was investigated by the Symptom Checklist-90-Revised (SCL-90-R) and the Mini-mental State Examination. The COPE Inventory was used to identify cognitive and behavioral strategies to manage disease-related distress.

Results: In testosterone-treated KS patients, when compared with controls, SCL-90-R subscales analysis evidenced high psychological distress, mainly presented as obsessive thoughts, hanger-hostility, phobias, and psychoticism. Self-directedness and self-transcendence, along with the prevalent use of emotion-focused coping strategies, outlined the personality of our KS patients. Depression and somatization proved to be predictors of general life dissatisfaction. Depression, anger-hostility, and paranoid ideation, instead, emerged as predictors of sexual life dissatisfaction.

Conclusion: Endocrinologists should cooperate with mental health providers to foster a better outcome of the disease in KS patients.

Keywords: Coping strategies; Genetic disorder; Klinefelter syndrome; Personality traits; Quality of life; Testosterone replacement therapy.

Publication types

  • Observational Study

MeSH terms

  • Adaptation, Psychological / physiology*
  • Adult
  • Cognition*
  • Hormone Replacement Therapy* / methods
  • Hormone Replacement Therapy* / psychology
  • Humans
  • Italy / epidemiology
  • Klinefelter Syndrome* / epidemiology
  • Klinefelter Syndrome* / psychology
  • Klinefelter Syndrome* / therapy
  • Male
  • Mental Health
  • Mental Status and Dementia Tests
  • Personality Assessment
  • Psychological Distress
  • Quality of Life*
  • Sexual Behavior
  • Testosterone / therapeutic use*

Substances

  • Testosterone