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A Case of Cushing Syndrome Misdiagnosed as Treatment-Resistant Depression

Published:October 12, 2019DOI:https://doi.org/10.1016/j.amjmed.2019.09.010
      Cushing's syndrome is a systemic disease resulting from chronic exposure to cortisol excess, occurring at a rate of 0.7 to 2.4 per million per year.
      • Santos A
      • Resmini E
      • Pascual JC
      • et al.
      Psychiatric symptoms in patients with Cushing's syndrome: prevalence, diagnosis and management.
      ,
      • Newell-Price J
      • Bertagna X
      • Grossman AB
      • et al.
      Cushing's syndrome.
      An abundance of glucocorticoid receptors found in the central nervous system makes the brain susceptible to states of glucocorticoid excess.
      • Santos A
      • Resmini E
      • Pascual JC
      • et al.
      Psychiatric symptoms in patients with Cushing's syndrome: prevalence, diagnosis and management.
      Depression is the most common neuropsychiatric manifestation of Cushing's syndrome, present in 50%-80% of patients with active disease, with suicidal ideation reported at a rate of 17%.
      • Santos A
      • Resmini E
      • Pascual JC
      • et al.
      Psychiatric symptoms in patients with Cushing's syndrome: prevalence, diagnosis and management.
      Neuropsychiatric symptoms can precede the onset of Cushing's syndrome,
      • Bratek A
      • Kozmin-Burzynska A
      • Gorniak E
      • et al.
      Psychiatric disorders associated with Cushing's syndrome.
      making diagnosis challenging.

      Keywords

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      References

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        • Resmini E
        • Pascual JC
        • et al.
        Psychiatric symptoms in patients with Cushing's syndrome: prevalence, diagnosis and management.
        Drugs. 2017; 77: 829-842
        • Newell-Price J
        • Bertagna X
        • Grossman AB
        • et al.
        Cushing's syndrome.
        Lancet. 2006; 367: 1605-1617
        • Bratek A
        • Kozmin-Burzynska A
        • Gorniak E
        • et al.
        Psychiatric disorders associated with Cushing's syndrome.
        Psychiatr Danub. 2015; 27: S339-S343