Objective: To study the frequency and features of mental disorders in hospitalized patients, suffering from Cushings disease (CD).
Materials and methods: We studied 70 patients (59 women and 11 men) with verified diagnosis of CD, aged 41±12 years. Their mental health was evaluated with ICD-10 criteria and verified by the Mini-International Neuropsychiatric Interview questionnaire (MINI 6.0). 45 patients had overt hypercortisolism (untreated CD and relapse), 25 people had remission after treatment.
Results: Majority of the patients with CD suffered from comorbid mental disorders (88.5%). 61.6% of them had different forms of affective disorders including bipolar disorder in 22/70 (38%), hypomania in 8/70 (11.2%), depressive episode in 6/70 (8.4%), mania without psychotic symptoms 3/70 (4.2%), recurrent affective disorder 3/70 (4.2%) and cyclothymia in 2/70 (2.8%) patients. The frequency of neurotic, stress and somatoform disorders was 15/70 (21%), among these, the frequency of obsessive-compulsive disorder (6/70, 8.4%) was higher than population-based, while the frequencies of social phobia (3/70, 4.2%), panic disorder (2/70, 2.8%), agoraphobia without panic attacks (2/70, 2.8%) and adjustment disorder (2/70, 2.8%) were not increased. The rest of diagnoses did not exceed population prevalence: unspecified dementia in 1 (1.4%), acute psychotic disorder in 1 (1.4%), schizoid personality disorder in 1 (1.42%). Psychiatric comorbidity with presence of two or more mental disorders in the same patient reached 37/70 (52.8%). The frequency of bipolar spectrum disorders and anxiety disorders was similar in patients with active hypercortisolism and remission, although the lack of difference may be due to the small sample size.
Conclusions: Mental disorders in patients with CD are extremely high. A prominent frequency of bipolar spectrum disorders and recurrent depression suggests, that the dysregulation of biological cycles is an important mechanism of CD development/recurrence. Besides, there are obviously specific psychological adaptation patterns and a number of typical stress responses in such patients.
20 - 23 May 2017
European Society of Endocrinology