Diagnostic categorization of psychiatric disturbance in Cushing's syndrome

The author obtained a longitudinal psychiatric history from 30 patients with proven Cushing's syndrome. Twenty-five (83%) of the patients met strict diagnostic criteria for an episode of affective disorder during the course of their endocrine disturbance. Twenty patients met criteria for endogenous depression and eight patients also reported an episode of mania or hypomania. Schizophrenic syndromes were not evident, although two patients met criteria for a psychotic depression. Patients frequently attempted to minimize or conceal serious psychiatric disturbance, including a suicide attempt. Typical affective syndromes occurred in patients with adrenocortical tumors as well as in those with ACTH-dependent Cushing's syndrome.