Journal Article

Psychiatric Symptoms in Patients with Cushing’s Syndrome: Prevalence, Diagnosis and Management

Webb, Susan M., Pascual, Juan Carlos, Resmini, Eugenia, Santos, Alicia, Crespo, Iris

2017

Overview

Cushing’s syndrome (CS) results from chronic exposure to cortisol excess, produced by the adrenal cortex. Hypercortisolism predisposes to psychiatric and neurocognitive disorders, mainly to depression and anxiety disorders. Screening tools to identify psychiatric symptoms are available for clinicians in their daily practice, although a specific diagnosis should be performed by specialists. Even if psychiatric symptoms improve after remission of hypercortisolism, complete recovery may not be achieved. Given the burden of these symptoms, psychiatric or psychological monitoring and treatment should be offered through all phases of CS, with a multidisciplinary approach. The aim of this article is to review data on the prevalence, diagnosis and management of psychiatric symptoms seen in patients with CS and to propose therapeutic approaches that may be followed in clinical practice. The prevalence of different psychiatric disorders has been described in both the active phase and after CS remission. Patients may not talk spontaneously about psychiatric symptoms they present, thus clinicians should ask directly about them. We recommend the use of screening tools in clinical practice to detect and treat these symptoms promptly. Even if reference endocrinologists cannot perform a definite psychiatric diagnosis, it will be important to ask patients directly about the presence of symptoms and refer if necessary to a psychiatrist. Additionally, patient information and educational programmes could be useful to manage psychiatric symptoms and to improve quality of life in patients with CS.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Adrenal cortex / Adrenal Cortex - metabolism / Adrenal glands / Adrenocorticotropic hormone / Anxiety / Anxiety Disorders - diagnosis / Anxiety Disorders - epidemiology / Anxiety Disorders - etiology / Anxiety Disorders - therapy / Behavior disorders / Chronic exposure / Chronic illnesses / Clinical medicine / Cognition / Cushing syndrome / Cushing Syndrome - complications / Cushing Syndrome - psychology / Cushing Syndrome - therapy / Depressive Disorder - diagnosis / Depressive Disorder - epidemiology / Depressive Disorder - etiology / Depressive Disorder - therapy / Diagnosis / Disease Management / Disorders / Emotional disorders / Health and safety screening / Health risk assessment / Hormones / Humans / Hydrocortisone - metabolism / Hypertension / Internal Medicine / Medical diagnosis / Medicine / Medicine & Public Health / Mental depression / Mental disorders / Mental Disorders - diagnosis / Mental Disorders - epidemiology / Mental Disorders - etiology / Mental Disorders - therapy / Metabolism / Nervous system / Nervous system diseases / Neurocognitive Disorders - diagnosis / Neurocognitive Disorders - epidemiology / Neurocognitive Disorders - etiology / Neurocognitive Disorders - therapy / Patients / Pharmacology/Toxicology / Pharmacotherapy / Pituitary / Psychosis / Quality of Life / Remission / Stress / Studies / Therapy in Practice