Hypercortisolism and psychosis / 中华内分泌代谢杂志

ABSTRACT

Objective To studytherelationshipbetweenhypercortisolismand psychosis. Methods According to pathologic diagnosis, 133 cases of hypercortisolism were dividedinto adrenal lesion group, pituitary adenoma group and ectopic ACTH tumor group, and the relationship between hypercortisolism and psychosis was analyzed. Results (1) There were significant differences between groups regarding cortisol levels and the amplitude of fluctuation. (2) Depression and mania were the main manifestations of psychosis in the patients, and 79.7% of the patients showed symptoms of depression. (3) In ectopic ACTH tumor group, the level and the increased amplitude of 24 h urinary free cortisol were significantly higher than those in the other two groups, all the patients had severe depression, and the rate of suicide tendence (58.3%) was significantly higher than the other two groups. Conclusions (1) Psychosis has a close relationship with hypercortisolism,especially with the marked fluctuation in cortisol level. (2) Sufficient attention should be paid to this relationship, which will improve the diagnosisand treatment of hypercortisolism.