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Cushing's Syndrome: A Psychiatric Study of 29 Patients

  • Samuel I. Cohen (a1)


Among a consecutive unselected series of 29 patients with Cushing's syndrome 21 had bilateral adrenal hyperplasia and 8 had tumours. Twenty-five (86 per cent) were significantly depressed; three of the tumour patients, but only one of the hyperplasia group were free of symptoms so that if there are no psychiatric symptoms there is a three in four chance that the patient has a tumour. There was a family history of depression or suicide or a history of early bereavement or separation in half the cases. In six of the hyperplasia patients a major emotional disturbance had preceded the onset, and in five this was a loss. The severity of the depression was not related to the level of circulating Cortisol. The depression was rapidly relieved when the tumour or hyperplastic glands were removed. Depression in Cushing's syndrome might result from a substance other than Cortisol produced by the adrenal under excessive pituitary and/or hypothalamic stimulation, which could play a part in the aetiology of depressive illness in general.



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Brown, G. W., Harris, T. & Copeland, J. R. (1977) Depression and loss. British Journal of Psychiatry, 130, 118.
Carroll, B. J. (1976) Psychoendocrine relationships in affective disorders. In Modem Trends in Psychosomatic Medicine 3. Ed. Hill, O. W., pp 129–33. London: Butterworths.
Cushing, H. (1913) Psychiatric disturbances associated with disorders of the ductless glands. American Journal of Insanity, 69, 965–90.
Cushing, H. (1932) The basophil adenomas of the pituitary body and their clinical manifestations. Bulletin of the Johns Hopkins Hospital, 50, 137–95.
Furger, R. (1961) Psychiatrische Untersuchungen beim Cushing-Syndrome. Schweizer Archiv für Neurologic, Neurochirurgie und Psychiatric, 88, 939.
Gibbons, J. L. & McHugh, P. R. (1961–3) Plasma Cortisol in depressive illness. Journal of Psychiatric Research, 1, 162–71.
Gifford, S. & Gunderson, J. G. (1970) Cushing's disease as a psychosomatic disorder. A selective review of the clinical and experimental literature and a report of ten cases. Perspectives in Biology and Medicine, 13, 169221.
Hurxthal, L. M. & O'Sullivan, J. B. (1959) Cushing's Syndrome: clinical differential diagnosis and complications. Annals of Internal Medicine, 51, 116.
Maas, J. W. (1972) Adrenocortical steroid hormones, electrolytes and the disposition of the catecholamines with particular reference to depressive states. Journal of Psychiatric Research, 9, 227–41.
Quarton, G., Clark, L., Cobb, S., et al (1955) Mental disturbances associated with ACTH and Cortisone. Medicine (Baltimore), 34, 1350.
Sachar, E. J. (1975) Evidence for neuroendocrine abnormalities in major mental illnesses. In Biology of the Major Psychoses; Research Publications: Association for Research in Nervous and Mental Disease. New York: Raven Press, 54, 347–58.
Schwab, J. J., Bialow, M., Brown, J. M. & Holzer, C. E. (1967) Diagnosing depression in medical inpatients. Annals of Internal Medicine, 67, 695707.
Spillane, J. D. (1951) Nervous and mental disorders in Cushing's syndrome. Brain, 74, 7294.
Trethowan, W. H. & Cobb, S. (1952) Neuropsychiatric aspects of Cushing's syndrome. Archives of Neurology and Psychiatry, 67, 283309.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Cushing's Syndrome: A Psychiatric Study of 29 Patients

  • Samuel I. Cohen (a1)
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