J Neuropsychiatry Clin Neurosci 1990; 2:34-43
Copyright © 1990 by American Neuropsychiatric Association
Differential diagnosis and pathophysiology of Cushing's syndrome and primary affective disorder
A Krystal, KR Krishnan, M Raitiere, R Poland, JC Ritchie, NR Dunnick, K Hanada and CB Nemeroff
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27710.
Most patients with major depression have increased 24-hour urinary free
cortisol and cortisol nonsuppression after dexamethasone administration,
which are cornerstones of a diagnosis of Cushing's syndrome. Similarly,
Cushing's syndrome patients often suffer from major psychiatric syndromes,
most often depression. These similarities between the two conditions
sometimes make it difficult to differentiate them and have led some
investigators to suggest they are two points on a spectrum of
endocrinologic dysfunction. This article reviews the literature comparing
Cushing's syndrome and primary affective disorder and presents two cases
that illustrate just how closely these diseases may resemble one another.
