title: Cushing Disease Presenting as Primary Psychiatric Illness: A Case Report and Literature Review.
abstract: We report the case of a woman with long-standing refractory depression and psychotic features who was eventually diagnosed with Cushing disease. After surgical treatment of a pituitary adenoma, she experienced gradual psychiatric recovery and was eventually able to discontinue all psychotropic medication. We review the psychiatric components of Cushing disease, implications of psychiatric illnesses for the treatment and prognosis of Cushing disease, and potential pathophysiological mechanisms linking glucocorticoid excess to psychiatric illness.
authors.affiliation: RASMUSSEN, MAZUREK: Department of Medicine ROSEBUSH: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; SMYTH: Department of Neurosurgery, Trillium Health Centre, Mississauga, ON, Canada.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Rasmussen
authors.forename: Patricia I
authors.initials: PI
authors.lastname: Rosebush
authors.forename: Harley S
authors.initials: HS
authors.lastname: Smyth
authors.forename: Michael F
authors.initials: MF
authors.lastname: Mazurek
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007016:Hypophysectomy / Q000379:methods*; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000601:surgery*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome