Psychiatry and Clinical Psychopharmacology

A case report: organic affective disorder caused by Cushing’s Syndrome

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S344-S344
Read: 650 Published: 17 February 2021

Cushing syndrome (CS) is the condition of cortisol dysregulation, and cortisol dysregulation is the prototypic finding in affective disorders. In CS, chronic, stress-level concentrations of cortisol lead to melancholic or psychotic or mixed bipolar features, vegetative symptoms, abnormal sleep profiles and cognitive dysfunction, especially in memory. In addition, there is evidence of reduced regional brain volumes in the hippocampus, as well as decreased glucose utilization during active hypercortisolism. N.T. 35-year old woman, was admitted to the hospital with thoughts of guilt and failure, forgetfulness, inability to house and care for their child, unhappiness, loss of appetite. Cushing’s symptoms had begun five years ago and after detection of an adenoma, she has been operated 4 years ago. She could not adequately deal with her children, forgetfulness, hearing voices, seeing images, feeling to tap one her body has begun. She has been hospitalized in a foreign center and diagnosed with depression, atypical psychosis and severe depression with psychotic symptoms. After two months of remission, complaints started again. She tried to suicide 3 times. Her husband abandoned 3 years ago then thoughts of failure developed. Due to the improper conducts like beggary by throwing herself in front of car and suicidal thoughts, she was admitted to our hospital and treated sertraline 50 mg/day. Alexander IQ test was 87. She could not adapt to the Rorschach, was identified paranoid features in MMPI. In neurocognitive battery, site and time orientation was poor, executive functions and reasoning skills-interpret was good, arithmetic skills was inadequate, components of attention, logical memory, verbal and visual memory was weak. She was treated with 9 sessions of ECT. Because the disappearance of suicidal idea and the mood was euthymic, she was discharged with a diagnosis of Mood Disorder Due to the General Medical Condition. Because she did not use her drugs regularly, she admitted to the polyclinic with depressive symptoms. In endocrine disorders, psychiatric symptoms are seen often. In the differential diagnosis of psychiatric disorders that should be considered. Because of more responsive and comprehensive imaging and blood tests, mental disorders caused by organic feature can be diagnosed earlier and more accurate. On the other hand, it is also important for the treated patients in section of endocrinology to be evaluated in psychiatric aspect.

EISSN 2475-0581