title: Neuropsychiatric findings in Cushing syndrome and exogenous glucocorticoid administration.
abstract: This article reviews the neuropsychiatric presentations elicited by spontaneous hypercortisolism and exogenous supraphysiologic glucocorticoids. Patients with Cushing disease and syndrome develop a depressive syndrome: irritable and depressed mood, decreased libido, disrupted sleep and cognitive decrements. Exogenous short-term glucocorticoid administration may elicit a hypomanic syndrome with mood, sleep and cognitive disruptions. Treatment options are discussed. Brain imaging and neuropsychological studies indicate elevated cortisol and other glucocorticoids are especially deleterious to hippocampus and frontal lobe. The research findings also shed light on neuropsychiatric abnormalities in conditions that have substantial subgroups exhibiting elevated and dysregulated cortisol: aging, major depressive disorder and Alzheimer's disease.
authors.affiliation: Department of Psychiatry, University of Michigan Medical Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. Starkman@umich.edu
authors.forename: Monica N
authors.initials: MN
authors.lastname: Starkman
mesh_terms: D001921:Brain / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D003480:Cushing Syndrome / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans
chemical_list: D005938:Glucocorticoids
keywords: Brain imaging; Cognition; Cushing disease and Cushing syndrome; Depressive disorder; Elevated cortisol; Exogenous glucocorticoid administration; Hypomania; Management