Journal of Clinical and Molecular Endocrinology

Neuropsychiatric manifestations of Cushing s syndrome A Mini-review

Cushing’s syndrome is an endocrine disorder that is challenging to the managing physician due to its diverse presentations. The underlying endocrine abnormality isthe exposures of various organsto excess glucocorticoidsfor a prolonged period. This makes the disease to present with various symptoms and signs in different organ systems. However, despite prominent neuropsychiatric features present in Cushing’s syndrome, the published works on these features are relatively scanty. Thismini-review aimsto give an overview ofthe various neuropsychiatric disorders in Cushing’s syndrome. The effects of excess steroids on the neuronal cells and supporting glial cells in the brain are the underling pathophysiologic mechanisms by which Cushing’s syndrome manifest with neuropsychiatric disorders. Brain atrophy due to excitotoxicity and impaired neurogenesis are some of the reported mechanisms. Functional neuroimaging have supported these mechanisms. Mood disorders are the most common psychiatric manifestation of Cushing’s syndrome. Patients may present with varying severity of depressive illness. Some even have suicidal ideation and attempts. Manic episodes have also been reported. Cognitive disorders, characterized by impairment in various domains of cognition such as attention, memory, visuospatial orientation, judgment and verbal fluency have been reported in the literature. Psychotic disorders are rare but their presentation may precede the diagnosis of Cushing’s syndrome and they may not respond to the usual antipsychotic medications. Accurate diagnosis and treatment of Cushing’s syndrome is usually associated with resolution of the psychotic symptoms. Generalized anxiety disorder and panic disorders have also been scantily reported in Cushing’s syndrome. In rare instances, some of these neuropsychiatric features persist even after resolution of the endocrine disease

Author(s):

Azeez Taoreed Adegoke, Lawal Abimbola Olukayode, AlakejiIsaacAderibigbe

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