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28 February 2015

Drawing tests show cured growth disorder patients do not feel cured

A simple drawing test could help doctors assess the psychological impact of the rare disease acromegaly, according to a new study published on Rare Disease Day 2015 in the European Journal of Endocrinology.
Commonly associated with gigantism, acromegaly can be treated by bringing excess growth hormone levels in the blood back to normal. However, physical symptoms like a protruding forehead and enlarged hands, feet and tongue can be difficult to reverse and many patients do not feel cured after being treated for the disease.
By asking them to draw their perceived symptoms, doctors can provide patients with a relatively easy and comfortable way of sharing their concerns without causing embarrassment.
To find out how useful a drawing test is in assessing the psychological impact of acromegaly, fifty adults considered completely cured of acromegaly were asked to draw three pictures: the first showing how they thought their bodies looked like before they developed the disease, the second showing their body during treatment and the third showing how they look like currently. The patients were also asked to fill in a questionnaire to determine their quality of life and another questionnaire to find out how they perceived their illness.
The researchers found that despite being technically cured, patients still suffered from negative feelings and perceptions related to acromegaly. The patients’ first drawings showed healthy individuals and reflected no pain, negative emotions or symptoms of acromegaly.
However, the head, hands and feet in the second and third drawings were significantly larger and wider compared to the first, suggesting the patients still perceived themselves as suffering from the symptoms of acromegaly despite having been treated successfully.
The researchers also found that patients who drew larger drawings of their symptoms had more negative perceptions about their illness and suffered from a lower quality of life.
“Patients are labelled ‘cured’ by medical doctors but still feel like a patient with acromegaly”, said lead author of the study and University of California at Merced researcher Dr Jitske Tiemensma. “It might be difficult for a patient to bring up lingering physical symptoms and medical doctors might not always recognise what’s going on”.
“We think that these drawings have the potential to function as a source of information healthcare providers are less likely to receive otherwise”, said Dr Tiemensma.
The researchers are next considering examining the use of drawings over the full course of acromegaly and how they expect to look like after treatment, to be able to later look back on it after being cured.
A disease or disorder is defined as rare in Europe when it affects less than 1 in 2000. One in 500,000 people are diagnosed with acromegaly each year, making it a very rare disease. Medical treatment can be expensive, ranging from €20-60,000 per year.

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