Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T12:18:32.643Z Has data issue: false hasContentIssue false

Cushing's Syndrome and Depression—A Prospective Study of 26 Patients

Published online by Cambridge University Press:  29 January 2018

William F. Kelly
Affiliation:
Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Stuart A. Checkley
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SE5
David A. Bender
Affiliation:
Courtauld Institute of Biochemistry, The Middlesex Hospital Medical School, London W1P 7PN
Keith Mashiter
Affiliation:
Hammersmith Hospital, Du Cane Road, London W12 0HS

Summary

Of 26 patients with active Cushing's syndrome assessed before and at three and 12 months after treatment, 21 had pituitary-dependent disease. Median urinary free Cortisol values (per 24 hours) were 680, 180 and 200 nmol at zero, three and 12 months (normal <270 nmol), with significant improvement (P <0.001) at three and 12 months. Depression on the Hamilton rating scale was significantly less at three months (P <0.01) and at 12 months (P <0.001). We have already demonstrated that some patients with Cushing's syndrome have PSE diagnoses of depression and are more depressed than patients with other pituitary tumours. This is the firmest evidence to date that when Cushing's syndrome occurs it commonly causes depressive illness.

Type
Papers
Copyright
Copyright © 1983 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beardwell, C. G., Burke, C. W. & Cope, C. L. (1968) Urine free Cortisol measured by competitive protein binding. Journal of Endocrinology, 42, 7989.Google Scholar
Bender, D. A. & Bamji, A. N. (1974) Serum tryptophan binding in chlorpromazine-treated chronic schizophrenics. Journal of Neurochemistry, 22, 805–9.Google Scholar
Cohen, S. I. (1980) Cushing's Syndrome: A psychiatric study of 29 patients. British Journal of Psychiatry, 136, 120–4.Google Scholar
Connell, P. H. (1958) Amphetamine Psychosis. Maudsley Monograph. London: Oxford University Press.Google Scholar
Curzon, G. & Green, A. R. (1971) Regional and subcellular changes in the concentration of 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in rat brain caused by hydrocortisone DL-α-methyl-tryptophan 1-kynurenine and immobilisation. British Journal of Pharmacology, 43, 3952.CrossRefGoogle Scholar
Cushing, H. (1913) Psychiatric disturbances associated with disorders of the ductless glands. American Journal of Insanity, 69, 965–90.Google Scholar
Cushing, H. (1932) The basophil adenomas of the pituitary gland and their clinical manifestations (pituitary basophilism). Bulletin of the Johns Hopkins Medical School, 50, 137–95.Google Scholar
Denckla, W. D. & Dewey, H. K. (1967) The determination of tryptophan in plasma, liver and urine. Journal of Laboratory and Clinical Medicine, 69, 160–9.Google Scholar
Green, A. R. & Curzon, G. (1968) Decrease of 5-hydroxytryptamine in the brain provoked by hydrocortisone and its prevention by allopurinol. Nature, 220, 1095–7.Google Scholar
Green, A. R., Woods, H. F., Knott, P. J. & Curzon, G. (1975) Factors affecting influence of hydrocortisone on rat brain tryptophan metabolism. Nature, 255, 270.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–96.Google Scholar
Hurxthal, L. M. & O'Sullivan, J. B. (1959) Cushing's Syndrome: clinical differential diagnosis and complications. Annals of Internal Medicine, 51, 116.Google ScholarPubMed
Jeffcoate, W. J., Silverstone, J. T., Edwards, C. R. W. & Besser, G. M. (1979) Psychiatric manifestations of Cushing's syndrome: Response to lowering of plasma Cortisol. Quarterly Journal of Medicine, 191, 465–72.Google Scholar
Kelly, W. F., Checkley, S.A., & Bender, D. A. (1980) Cushing's syndrome, tryptophan and depression. British Journal of Psychiatry, 136, 125–32.Google Scholar
Mobley, P. L. & Sulser, F. (1980) Adrenal corticoids regulate sensitivity of noradrenaline receptor-coupled adenylate cyclase in brain. Nature, 286, 608–9.Google Scholar
Siegel, S. (1956) Non-Parametric Statistics for the Behavioral Sciences. Tokyo: McGraw Hill Kogakusha.Google Scholar
Spillane, J. D. (1951) Nervous and mental disorders in Cushing's Syndrome. Brain, 74, 7294.Google Scholar
Trethowan, W. H. & Cobb, S. (1952) Neuropsychiatric aspects of Cushing's Syndrome. Archives of Neurology and Psychiatry, 67, 283309.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.