Psychosomatic View of Endocrine Disorders

Fava, Giovanni A.; Sonino, Nicoletta; Morphy, Murray A.

doi:10.1159/000288641

Cited by 37 publications

(45 citation statements)

References 72 publications

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“…Várias investigações têm sugerido o papel de eventos pessoais estressantes sobre distúrbios endócrinos em indivíduos vulneráveis (Fava et al, 1993;Sonino e Fava, 1998;Sobrinho, 2004). É bem conhecido o efeito do estresse psicológico agudo sobre a elevação dos valores de prolactina em indivíduos saudáveis, sendo observados irregularidades menstruais, galactorréia e/ou outros sintomas de hiperprolactinemia associados com acontecimentos na vida pessoal (Biondi e Picardi, 1999).…”

Section: Hiperprolactinemia E Psiquismounclassified

Estados hiperprolactinêmicos: inter-relações com o psiquismo

Nahás

Nahás-Neto

Pontes

et al. 2006

Rev. psiquiatr. clín.

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ResumoA hiperprolactinemia é o distúrbio endócrino mais freqüente do eixo hipotálamo-hipofisário, observado em mulheres na idade reprodutiva. Caracteriza-se pela elevação consistente dos valores plasmáticos de prolactina. A regulação da produção da prolactina dá-se por meio da ação inibitória de um neurotransmissor, a dopamina. As manifestações clínicas são distúrbios do ciclo menstrual, amenorréia, galactorréia, infertilidade e diminuição da libido. Entretanto, sintomas psicológicos, especialmente ansiedade e depressão, têm sido associados à hiperprolactinemia. Contudo, há poucos estudos clínicos publicados sobre o tema. O papel da prolactina na patogênese dos distúrbios psiquiátricos pode refletir ação direta sobre o sistema nervoso central, efeito indireto por meio dos hormônios gonadais ou constituir fatores independentes, resultantes da depleção de dopamina. Assim, detectada a prevalência de distúrbios psiquiátricos em pacientes com hiperprolactinemia, conclui-se pela necessidade de maior número de pesquisas que investiguem as bases da possível inter-relação entre os estados hiperprolactinêmicos e o psiquismo.Palavras-chaves: Hiperprolactinemia, psiquismo, dopamina. AbstractHyperprolactinemia is the most frequent endocrine disorder of the hypothalamus-hypophysis axis observed in women of reproductive age. It is characterized by elevated serum prolactin levels. Prolactin production is regulated by the inhibitory action of a neurotransmitter, dopamine. Clinical manifestations include irregular menstrual cycle, amenorrhea, galactorrhea, infertility and libido decrease, but psychological symptoms, especially anxiety and depression, have also been associated with hyperprolactinemia. Nonetheless, few studies about this condition are available. In the pathogenesis of psychiatric disorders, prolactin may have either a direct action on the central nerve system or an indirect effect via gonadal hormones or function as independent factors as a result of dopamine depletion. Thus, since the prevalence of psychiatric disorders in patients with hyperprolactinemia was detected, it was concluded that further studies are necessary to investigate the basis of a potential relationship between both hyperprolactinemic and psychiatric conditions.

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Section: Hiperprolactinemia E Psiquismounclassified

Estados hiperprolactinêmicos: inter-relações com o psiquismo

Nahás

Nahás-Neto

Pontes

et al. 2006

Rev. psiquiatr. clín.

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“…The symptoms of irritability, mood behaviors, distress, depression, and to a minor extent psychosis, have been reported by a number of studies to be associated with the disease [25][26][27]. Anglin et al,[25] brings up the point that psychiatric symptoms may even be the only symptoms present in Addison's disease patients, so it is important when seeing these symptoms to maintain a high index of suspicion for this potentially fatal condition.…”

Section: Introductionmentioning

confidence: 99%

“…Kathol and Delahunt [48] reported that 60% of their hyperthyroid patients were found to have an anxiety disorder. Furthermore, several other studies have found these symptoms as well as other psychiatric symptoms associated with Grave's disease which include hypomania, mania, depression, psychosis, insomnia, attention and over activity problems, restlessness, fatigue, and delirium [26,[49][50][51][52][53][54][55][56][57][58]. As far as treatment, there are discrepancies with some studies that have found that psychiatric symptoms like anxiety generally improve with the treatment of hyperthyroidism [26,48,59].…”

mentioning

confidence: 96%

“…Furthermore, several other studies have found these symptoms as well as other psychiatric symptoms associated with Grave's disease which include hypomania, mania, depression, psychosis, insomnia, attention and over activity problems, restlessness, fatigue, and delirium [26,[49][50][51][52][53][54][55][56][57][58]. As far as treatment, there are discrepancies with some studies that have found that psychiatric symptoms like anxiety generally improve with the treatment of hyperthyroidism [26,48,59]. However, other studies have reported that psychiatric symptoms persisted despite appropriate anti-thyroid treatment [47,[60][61][62][63].…”

mentioning

confidence: 96%

“…Since then, numerous studies have been working to characterize the psychological symptoms associated with hypothyroidism. In a study of 2,142 individuals diagnosed with thyroid disorders, Ittermann et al, [65] psychological problems associated with hypothyroidism including attention deficits and cognitive disturbances [26,50,[66][67][68]. …”

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confidence: 99%

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Psychiatric Manifestations of Endocrine Disorders

Solomon¹

2017

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The endocrine system has been studied extensively from physiological, biochemical, and molecular approaches. However, much less attention has concentrated on the psychological aspects associated with these different endocrine diseases, and the necessity of addressing these psychological issues in order to effectively treat endocrine patients. Often, there is a significant impairment in the quality of life when it comes to these different endocrine diseases, and an interdisciplinary approach is needed in order to achieve the best possible outcome for the patient. It is our goal through this review to provide a comprehensive assessment of the psychological implications associated with different endocrine disorders. Specifically, we will address the psychological aspects associated with diabetes, Cushing's syndrome, Addison's disease, hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoparathyroidism, pheochromocytoma, and androgen and estrogen disorders, as well as a brief correlation of transgender adults. Adrenal: Cushing's Syndrome and Addison's DiseaseOver the past few decades, a number of authors have found a significant amount of psychological disorders associated with Cushing's syndrome. Sonino and Fava [1] found that major depression is a life-threatening complication, which may affect 50-60% of patients with Cushing's syndrome. They found that it occurs in both the pituitary dependent and independent forms of the disease. Kelly et al., [2] found a similar association with 57% of 209 Cushing's syndrome patients having a significant psychiatric illness, usually depression. A follow-up study by Sonino et al.,[3] found that 54% of patients with pituitary-dependent Cushing disease had major depression according to DSM-IV criteria. They observed that the depression in Cushing's syndrome was significantly associated with female gender, older age, higher urinary cortisol levels, a relatively more severe clinical condition, and an absence of a pituitary adenoma. Other authors have also found the same correlation between depression and Cushing's syndrome [1,[4][5][6][7]. While depression is one of the most important psychological symptoms associated with Cushing's syndrome, other symptoms have been noticed. Starkman et al., [8] and Starkman [9] reported that around 66% of their Cushing's syndrome patients experienced generalized anxiety or panic disorders. Sonino et al., [10] also found a significant association between anxiety and Cushing's syndrome. In this same particular study, the authors also saw there was a significant association in their Cushing's syndrome patients with increased irritable mood, higher levels of stress, and lower physical well-being. Mania and hypomania are other psychological symptoms that have been associated with Cushing's syndrome by a number of authors [11,12].There has been a significant debate in the literature whether the psychological symptoms of Cushing's syndrome completely resolve after the remission of the disease. Several studies have found significant improvements or e...

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Depressiv-ängstliche Störungen bei somatischen Krankheiten

Hp¹

2003

Psychiatrie Und Psychotherapie

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D epressiv-ängstliche Störungen sind bei den unterschiedlichen somatischen Erkrankungen häufig. Sie sind nicht nur als Reaktion auf die Situation der Erkrankung zu verstehen, sondern in ein komplexes Bedingungsgefüge eingebettet. Sie sind besonders häufig bei Erkrankungen, die das Zentralnervensystem oder endokrine Regulationsysteme direkt betreffen. Außerdem besteht ein enger Zusammenhang zur Chronizität, Schwere und Prognose der Erkrankung. Eigenständige Effekte von diversen pharmakologischen Substanzgruppen sind wahrscheinlich. Beim Verlauf somatischer Erkrankungen sind negative Auswirkungen koexistenter depressiv-ängstlicher Störungen auf die psychosoziale Adaptation, das medizinische Inanspruchnahmeverhalten, die Morbidität und Mortalität zu beachten. Psychotherapeutische Verfahren besitzen einen wichtigen Stellenwert im Gesamtbehandlungsplan. Differenzierte psychopharmakologische Strategien sind für die einzelnen somatischen Erkrankungen unter Kenntnis wichtiger Nebenwirkungen, der Interaktionen mit Internistika und der pathophysiologischen Grundbedingungen der somatischen Erkrankung verfügbar. 62.1 Einleitung Ängste und Depressionen sind sehr häufige Begleitumstände körperlicher Krankheiten. Im psychiatrischen Konsiliardienst stellen sie eine bedeutsame Hauptgruppe der Überweisungsgründe zur konsiliarischen Untersuchung und Mitbehandlung dar (s. Kap. 72). Aufgrund der besonderen Häufigkeit sowohl von somatischen Erkrankungen einerseits, von depressiven und Angststörungen andererseits in der Allgemeinbevölkerung mag ein zufälliges Zusammentreffen nicht überraschen. Diesem Sachverhalt kommt mit steigendem Lebensalter eine zunehmende Bedeutung zu. Gerade im höheren Lebensalter können typische Depressionen, aber auch klinisch relevante Ängste erstmalig im Kontext zunehmend häufiger werdender somatischer Erkrankungen ausgelöst werden (Satlin 1998). Jenseits einer zufälligen epidemiologischen Koexistenz muß aber auch stets ein komplexes, interagierendes Bedingungsgefüge zwischen somatischen Krankheiten, Therapien und psychischen Störungen angenommen werden. Koexistenz bzw. Komorbidität von körperlicher Krankheit und psychischer Störung verweisen hierbei grundsätzlich auf 4 Hauptkategorien: Zufällige Koinzidenz. Trotz eines fehlenden kausalen Zusammenhangs zwischen psychischer Störung und körperlicher Krankheit bedeutet die zusätzliche psychische Störung in aller Regel eine Komplizierung für das Management der körperlichen Krankheit. Gemeinsame Ursache für psychische Störung und körperliche Krankheit. Aus einem belastenden negativen Lebensereignis können prinzipiell beide Erkrankungen resultieren. In der individuellen Sicht kann der Verarbeitung eines bestimmten Lebensgeschickes mitunter ein höherrangiger Stellenwert eingeräumt werden als der Bedeutung der körperlichen Krankheit und folglich zu einem stärkeren psychosozialen Streß führen. Psychische Störung verursacht körperliche Krankheit. Klinische Angst und Depression beeinflussen die Kapitel 62 Depressiv-ängstliche Störungen bei somatischen Krankheiten 62

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Psychosomatic View of Endocrine Disorders

Cited by 37 publications

References 72 publications

Estados hiperprolactinêmicos: inter-relações com o psiquismo

Estados hiperprolactinêmicos: inter-relações com o psiquismo

Psychiatric Manifestations of Endocrine Disorders

Depressiv-ängstliche Störungen bei somatischen Krankheiten

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