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Endocrine disorders

from Medical topics

Published online by Cambridge University Press:  18 December 2014

By
Eric A. Storch  and
Gary R. Geffken
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Eric A. Storch
Affiliation:
University of Florida
Gary R. Geffken
Affiliation:
University of Florida
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Psychiatric symptomatology related to endocrine disorders

Psychiatric symptoms are commonly present during the course of endocrine disorders, which complicates diagnostic decisions. Common symptoms across endocrine diagnoses include affective disturbances (e.g. depression, anxiety), cognitive dysfunction, dementia, delirium and psychosis. This article provides a review of the psychiatric morbidity within endocrine disorders. Conditions associated with dysfunction of the pituitary, thyroid, parathyroid, adrenals and gonads are reviewed, as well as diabetes mellitus.

Disorders of the thyroid

Hypothyroidism

Hypothyroidism is the most common pathological hormone deficiency and can be classified on the basis of its time of onset (congenital or acquired), level of endocrine dysfunction responsible (primary or secondary) and severity (overt or mild). Overt hypothyroidism has been associated with symptoms such as energy loss, weight gain, slowed reflexes, cold intolerance, weight gain, constipation, dry skin, bradycardia, hoarseness and slowed cognitive processing. However, as many as 60–70% of newly diagnosed patients do not experience significant symptomatology (Ladenson et al., 1997). Those with mild hypothyroidism also often do not have symptoms.

Psychiatric and neurological manifestations can include depression (Ladenson et al., 1997), anxiety (Sait Gonen et al., 2004), psychosis (Alp et al., 2004), ataxia (Price & Netsky, 1966), seizures (Woods & Holmes, 1977) and coma (Nicoloff & LoPresti, 1993). Overt hypothyroidism commonly manifests itself with cognitive impairment and depression. Psychiatric symptoms progress in a gradual course of neurocognitive deficits beginning with mental slowing followed by cognitive disturbances (e.g. short-term memory problems) and depression.

Type
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Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 696 - 699
Publisher: Cambridge University Press
Print publication year: 2007

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References

Abed, R. T., Clark, J., Elbadawy, M. H. F.et al. (1987). Psychiatric morbidity in acromegaly. Acta Psychiatrica Scandinavia, 75, 635–9.CrossRefGoogle Scholar
Alp, R., Saygin, M., Ucisik, M.et al. (2004). Initial presentation of Hashimoto's thyroiditis with psychotic symptoms: a case report. Bulletin of Clinical Psychopharmacology, 14, 83–7.Google Scholar
Auer, R. N. (1986). Progress review: hypoglycemic brain damage. Stroke, 17, 699–708.CrossRefGoogle Scholar
Bilezikian, J. P. & Silverberg, S. J. (2004). Asymptomatic primary hyperparathyroidism. New England Journal of Medicine, 350, 1746–51.CrossRefGoogle Scholar
Boscaro, M., Barzon, L., Fallo, F.et al. (2001). Update on Cushing's syndrome. Lancet, 357, 783–91.CrossRefGoogle Scholar
Brown, G. M. (1975). Psychiatric and neurologic aspects of endocrine disease. Hospital Practice, 10, 71–9.CrossRefGoogle Scholar
Caplan, R. D., Cobb, S. & French, J. R. (1979). White collar work load and cortisol: disruption of a circadian rhythm by job stress?Journal of Psychosomatic Research, 23, 181–92.Google Scholar
Cox, D. J. & Gonder-Frederick, L. (1992). Major developments in behavioral diabetes research. Journal of Consulting and Clinical Psychology, 60, 628–38.CrossRefGoogle Scholar
Crofford, L. J., Pillemer, S. R., Kalogeras, K. T.et al. (1994). Hypothalamic-pituitary-adrenal axis perturbations in patients with fibromyalgia. Arthritis Rheumatoid, 37, 1583–92.CrossRefGoogle Scholar
Crowne, E. C., Shalet, S. M., Wallace, W. H. B.et al. (1990). Final height in boys with untreated constitutional delay in growth and puberty. Archives of Disorders in Children, 65, 1109–12.CrossRefGoogle Scholar
Csapo, M. (1991). Psychosocial adjustment of children with short stature (achondroplasia): social competence, behavior problems, self-esteem, family functioning, body image, and reaction to frustrations. Behavior Disorders, 16, 219–24.CrossRefGoogle Scholar
Dantzer, C., Swendsen, J., Maurice-Tison, S.et al. (2003). Anxiety and depression in juvenile diabetes. A critical review. Clinical Psychology Review, 23, 787–800.CrossRefGoogle Scholar
Demitrack, M. A., Dale, J. K., Straus, S. E.et al. (1991). Evidence for impaired activation of the hypothalamic–pituitary–adrenal axis in patients with chronic fatigue syndrome. Journal of Clinical Endocrinology and Metabolism, 73, 1224–34.CrossRefGoogle Scholar
Downey, J., Ehrhardt, A. A., Gruen, R.et al. (1989). Psychopathology and social functioning in women with Turner syndrome. Journal of Nervous and Mental Disease, 177, 191–201.CrossRefGoogle Scholar
Downie, A. B., Mulligan, J., Stratford, R. J.et al. (1997). Are short normal children at a disadvantage? The Wessex Growth Study. British Medical Journal, 314, 97–100.CrossRefGoogle Scholar
Forget, H., Lacroix, A., Somma, M.et al. (2000). Cognitive decline in patients with Cushing's syndrome. Journal of the International Neuropsychological Society, 6, 20–9.CrossRefGoogle Scholar
Geffken, G. R., Ward, H. E., Staab, J. P.et al. (1998). Psychiatric morbidity in endocrine disorders. The Psychiatric Clinics of North America, 21, 473–80.CrossRefGoogle Scholar
Goldney, R. D., Phillips, P. J., Fisher, L. J.et al. (2004). Diabetes, depression, and quality of life: a population study. Diabetes Care, 27, 1066–70.CrossRefGoogle Scholar
Greenspan, F. S. (1997). The thyroid gland. In Greenspan, F. S., Strewler, G. J. (Eds.). Basic and Clinical Endocrinology (5th edn.). Stamford, CT: Appleton & Lange.
Harris, M. I. (1995). Diabetes in america (2nd edn.) NIH Publication No. 95–1468, pp. 1–14. National Diabetes Data Group, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.
Harris, M. I., Flegal, K. M., Cowie, C. C.et al. (1998). Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: the Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care, 21, 518–24.CrossRefGoogle Scholar
Holmes, C. S., Karlsson, J. A. & Thompson, R. G. (1985). Social and school competencies in children with short stature: longitudinal patterns. Journal of Developmental and Behavioral Pediatrics, 6, 263–7.CrossRefGoogle Scholar
Kowdley, K., Coull, B. M. & Orwoll, E. S. (1999). Cognitive impairment and intracranial calcification in chronic hypoparathyroidism. American Journal of Medical Science, 317, 273–7.CrossRefGoogle Scholar
Kinon, B. J., Gilmore, J. A., Liu, H.et al. (2003). Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone. Psychoneuroendocrinology, 28 (S2), 55–68.CrossRefGoogle Scholar
Ladenson, P. W., Braverman, L. E., Mazzaferri, E. L.et al. (1997). Comparison of recombinant human thyrotropin administration to thyroid hormone withdrawal for radioactive iodine scanning in patients with thyroid carcinoma. New England Journal of Medicine, 337, 888–96.CrossRefGoogle Scholar
Leigh, H. & Kramer, S. I. (1984). The psychiatric manifestation of endocrine disorders. Advances in Internal Medicine, 29, 413–45.Google Scholar
Levine, Y. & Gaoni, B. (1990). The hypoparathyroid syndrome: psychiatric observations and case description. Israel Journal of Psychiatry and Related Sciences, 27, 242–6.Google Scholar
Loosen, P. T., Chanbliss, B., DeBold, C. R.et al. (1992). Psychiatric phenomenology in Cushing's disease. Pharmacopsychiatry, 25, 192–8.CrossRefGoogle Scholar
Lustman, P. J., Griffith, L. S., Clouse, R. E.et al. (1986). Psychiatric illness in diabetes mellitus: relationship to symptoms and glucose control. Journal of Nervous and Mental Disease, 174, 735–42.CrossRefGoogle Scholar
Margo, A. (1981). Acromegaly and depression. British Journal of Psychiatry, 139, 467–8.CrossRefGoogle Scholar
Marx, S. J. (2000). Hyperparathyroid and hypoparathyroid disorders. New England Journal of Medicine, 343, 1863–75.CrossRefGoogle Scholar
Mauri, M., Sinforiani, E., Bono, G.et al. (1993). Memory impairment in Cushing's disease. Acta Neurological Scandinavia, 87, 52–5.CrossRefGoogle Scholar
Nicoloff, J. T. & LoPresti, J. S. (1993). Myxedema coma: a form of decompensated hypothyroidism. Endocrinology Metabolic Clinics of North America, 22, 279–90.CrossRefGoogle Scholar
Papa, A., Bononi, F., Sciubba, S.et al. (2003). Primary hyperparathyroidism: acute paranoid psychosis. American Journal of Emergency Medicine, 21, 250–1.CrossRefGoogle Scholar
Petty, R. G. (1999). Prolactin and antipsychotic medications: mechanism of action. Schizophrenia Research, 35, S67–S73.CrossRefGoogle Scholar
Price, T. R. & Netsky, M. G. (1966). Myxedema and ataxia: cerebellar alterations and “neural myxedema bodies”. Neurology, 16, 957–62.CrossRefGoogle Scholar
Radanovic-Grguric, L., Filakovic, P., Jelena, B.et al. (2003). Depression in patients with thyroid dysfunction. European Journal of Psychiatry, 17, 133–44.Google Scholar
Sait Gonen, M., Kisakol, G., Savas Cilli, A.et al. (2004). Assessment of anxiety in subclinical thyroid disorders. Endocrinology Journal, 51, 311–15.Google Scholar
Sheehan, D. V. & Sheehan, K. H. (1982). The classification of anxiety and hysterical states: towards a more heuristic classification. Journal of Clinical Psychopharmacology, 2, 386–93.CrossRefGoogle Scholar
Silverberg, S. J. (2002). Non-classical target organs in hyperparathyroidism. Journal of Bone and Mineral Research, 17 (Suppl. 2), N117–125.Google Scholar
Sonino, N. & Fava, G. A. (2001). Psychiatric disorders associated with Cushing's syndrome. Epidemiology, pathophysiology, and treatment. CNS Drugs, 15, 361–73.CrossRefGoogle Scholar
Stabler, B., Clopper, R. R., Siegel, P. T.et al. (1996). Links between growth hormone deficiency, adaptation, and social phobia. Hormone Research, 45, 30–3.CrossRefGoogle Scholar
Stern, R. & Prange, A. (1991). Neuropsychiatric aspects of endocrine disorders. In Kaplan, H. & Sadock, B. (Eds.). Comprehensive textbook of psychiatry. Baltimore: Williams and Wilkins.
Storch, E. A., Lewin, A., Silverstein, J. H.et al. (2005). Psychological adjustment of children with short stature: a comparison of children with short stature and type one diabetes. Journal of Pediatric Endocrinology and Metabolism, 18, 395–401.Google Scholar
Takami, H., Ikeda, Y., Okinaga, H.et al. (2003). Recent advances in the management of primary hyperparathyroidism. Endocrine Journal, 50, 369–77.CrossRefGoogle Scholar
Tran, P. V., Hamilton, S. H., Kuntz, A. J.et al. (1997). Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. Journal of Clinical Psychopharmacology, 17, 407–18.CrossRefGoogle Scholar
Wakeling, A. (1972). Comparative study of psychiatric patients with Klinefelter's syndrome and hypogonadism. Psychological Medicine, 3, 139–54.CrossRefGoogle Scholar
Woods, K. L. & Holmes, G. K. (1977). Myxoedema coma presenting in status epilepticus. Postgraduate Medicine Journal, 53, 46–8.CrossRefGoogle Scholar
Yehuda, R. (1997). Sensitization of the hypothalamic-pituitary-adrenal axis in posttraumatic stress disorder. Annals of the New York Academy of Science, 821, 57–75.CrossRefGoogle Scholar

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