Neuropsychiatric Aspects of Cushing's Syndrome

SINCE Harvey Cushing's original description of a disease occurring in association with basophile adenoma of the pituitary gland, 1 it has become widely recognized that the characteristic clinical picture may occur not only in association with this specific anatomical lesion, but with a wider variety of pathological conditions. 2 Thus, it has become customary to speak of Cushing's syndrome rather than of Cushing's disease, and to apply the latter term, if at all, to those cases in which a basophile adenoma is demonstrable. Furthermore, it now seems clear that, whatever additional pathological changes are uncovered at autopsy, the clinical picture of both Cushing's disease and Cushing's syndrome can be regarded as the result of adrenocortical hyperfunction, whether neoplastic or hyperplastic in anatomical expression. As this study, therefore, is concerned principally with neuropsychiatric aspects, which are in themselves of a primary clinical nature, only the term Cushing's syndrome will be used