Depressed Mood and Other Psychiatric Manifestations of Cushingʼs Syndrome: Relationship to Hormone Levels

Starkman, Monica N.; Schteingart, D.E.; Schork, M. Anthony

doi:10.1097/00006842-198102000-00002

Cited by 274 publications

(113 citation statements)

References 21 publications

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“…Additionally, a link between elevated cortisol levels and mood alterations is suggested by investigations of patients with primary hypercortisolism caused by Cushing's syndrome. The syndrome is associated with symptoms similar to those of depression, including depressed or labile mood, fatigue, insomnia, poor concentration and decreased energy [92]. Patients with Cushing's syndrome have an increased incidence of depressive illness, with rates as high as 67% reported [93].…”

Section: Endocrinological Factorsmentioning

confidence: 99%

Type 1 diabetes mellitus and major depressive disorder: evidence for a biological link

et al. 2011

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Aims/hypothesis A growing body of research suggests that the prevalence of major depressive disorder (MDD) in children and youth with type 1 diabetes mellitus is significantly higher than that of youth without type 1 diabetes and is associated with increased illness severity. The objective of this article is to review the current literature on the pathophysiology of these two common diseases with respect to potential areas of overlapping biological dysfunction. Methods A search of English language articles published between 1966 and 2010 was conducted and augmented with manual review of reference lists from the identified publications. Results The evidence suggests plausible mechanisms whereby a biological relationship between type 1 diabetes and MDD may exist. These include the effects of circulating cytokines associated with autoimmune diabetes, the direct impact of insulin deficiency on neurogenesis/neurotransmitter metabolism, the effects of the chronic hyperglycaemic state, occurrence of iatrogenic hypoglycaemia and the impact of basal hyperactivity of the hypothalamic-pituitary-adrenal axis. Major depressive disorder (MDD) is highly prevalent among children and adolescents with type 1 diabetes mellitus. The prevalence of MDD among youth with type 1 diabetes (20-27%) is at least two to three times greater than the 5-8% background rate of MDD reported for non-diabetic youth [1, 2]. Early-onset MDD is severe, and in combination with diabetes (the third most common chronic disease in childhood), is associated with poorer diabetes control, increased Conclusions/interpretation

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Section: Endocrinological Factorsmentioning

confidence: 99%

Type 1 diabetes mellitus and major depressive disorder: evidence for a biological link

et al. 2011

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“…These neuroendocrinological abnormalities are knownto cause both glucose dysregulation and mooddisorders. For instance, Cushing's syndrome, which is characterized by hypersecretion of cortisol, is often associated with depression and glucose dysregulation (23)(24)(25)(26). These endocrinological abnormalities may play a role in the association betweendepression and insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance in Patients with Depression and its Changes in the Clinical Course of Depression: A Report on Three Cases Using the Minimal Model Analysis.

et al. 1999

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It has been reported that depression and diabetes mellitus often occur together, and insulin resistance has been observed in patients with depression. For further understanding of the relationship of depression to insulin resistance, three patients with depression were given the oral glucose tolerance test (OGTT) and the frequently sampled intravenous glucose tolerance test (FSIGT) with minimal model analysis before and after antidepressant treatment. Depressive patients showed decreased glucose tolerance, enhanced insulin secretion, and diminished insulin sensitively during OGTT and FSIGT. These abnormalities were resolved after their recovery from depression without changes in body weight or diet. (Internal Medicine 38: 257-260, 1999)

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“…Most CS patients have depression or emotional lability [112] especially if they are older, females and have severe hypercortisolism [93,113]. Even though, biochemical control improves these symptoms, 25% may still present psychopathology 1 year after cure [114,115].…”

Section: Psychological and Neuropsychological Featuresmentioning

confidence: 99%

Persistent Comorbidities in Cushing’s Syndrome after Endocrine Cure

Resmini

2014

Advances in Endocrinology

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It was assumed that resolution of hypercortisolism in Cushing syndrome (CS) was followed by normalization of morbidity; however, in the last decade evidence is accumulating that patients with cured CS still have increased morbidity and mortality after the biochemical control of hypercortisolism. Patients with CS have an increased cardiovascular and metabolic risk and persistent accumulation of central fat, with an unfavorable adipokine profile, not only during the active phase of the disease but also long after biochemical remission. Clinical management should be particularly careful in identifying global cardiovascular risk, as a primary goal during the followup of these patients, aimed at improving global vascular morbidity. Moreover bone mass is reduced not only due to the endogenous hypercortisolism but also due to duration and dose of exogenous glucocorticoid (GC) replacement therapy after surgery. Thus, therapy in operated patients with inhibition of the hypothalamic-pituitary-adrenal axis should be reduced to the lowest dose and duration possible. Specific treatments should be considered in patients with decreased bone mass, aimed at reducing the increased fracture incidence. Finally, cognitive and health related quality of life impairments, described in active disease, are still abnormal after endocrine cure. Thus, residual morbidity persists in cured CS, suggesting irreversibility of GC-induced phenomena, typical of chronic hypercortisolism.

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Depressed Mood and Other Psychiatric Manifestations of Cushingʼs Syndrome: Relationship to Hormone Levels

Cited by 274 publications

References 21 publications

Type 1 diabetes mellitus and major depressive disorder: evidence for a biological link

Type 1 diabetes mellitus and major depressive disorder: evidence for a biological link

Insulin Resistance in Patients with Depression and its Changes in the Clinical Course of Depression: A Report on Three Cases Using the Minimal Model Analysis.

Persistent Comorbidities in Cushing’s Syndrome after Endocrine Cure

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