Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-18T11:26:07.285Z Has data issue: false hasContentIssue false

18 - Endocrine disorders

from Part III - Working with specific units

Published online by Cambridge University Press:  10 December 2009

By
Antonio Lobo ,
M. Jesús Pérez-Echeverría  and
Antonio Campayo
Edited by
Geoffrey Lloyd  and
Elspeth Guthrie
Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
Get access

Summary

Introduction

The relationships between endocrine disturbances and psychiatric conditions have stirred considerable interest for several reasons (Lishman 1998). Historically, several authors have speculated about the role of hormones and endocrine disorders in relation to psychiatric conditions, and attention has been devoted to the role of hormones in relation to control and feedback processes in neural structures (Carroll et al. 1981). Psychiatric syndromes have consistently been described or documented in endocrine diseases (Kathol 2002; Lishman 1998) and may pose a real clinical challenge for the liaison psychiatrist, but the evidence in the literature to support his or her intervention is limited. This chapter reviews available data in relation to the characteristics and frequency of specific psychiatric syndromes in primary endocrine disturbances; issues of diagnosis and differential diagnosis; mechanisms of production of psychiatric symptomatology; and treatment issues, including response of psychiatric syndromes to treatment of the endocrinopathy and to psychotropic medication.

Epidemiology

Some experts have suggested that the most severe psychiatric syndromes are not as prevalent as in the past, due to improvements in diagnosis and treatment of endocrine diseases (Kathol 2002). Still, a high prevalence of psychiatric disturbances has been reported in most endocrine conditions, depression and anxiety being the most common presentations (Tables 18.1 and 18.2). As expected, lifetime prevalence is even higher in several reports (Eiber et al. 1997).

Keywords

calcium levelclinical endocrinologyCushing's syndromedepressionsymptomatologyendocrine disorderhypocalcaemia
Type
Chapter
Information
Handbook of Liaison Psychiatry , pp. 432 - 453
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abed, R. T., Clark, J., Elbadawy, M. H., et al. (1987). Psychiatric morbidity in acromegaly. Acta Psychiatrica Scandinavica, 75, 635–9.Google Scholar
Baschetti, R. (2000). Chronic fatigue syndrome: a form of Addison's disease. Journal of Internal Medicine, 247, 737–9.Google Scholar
Bauer, M. S. and Whybrow, P. C. (1990). Rapid cycling bipolar affective disorder. II. Treatment of refractory rapid cycling with high-dose levothyroxine: a preliminary study. Archives of General Psychiatry, 47, 435–40.Google Scholar
Baumgartner, A. (1993). Thyroid hormones and depressive disorders – critical overview and perspectives. Part 1: Clinical aspects. Nervenarzt, 64, 1–10.Google Scholar
Belanoff, J. K., Gross, K., Yager, A., et al. (2001). Corticosteroids and cognition. Journal of Psychiatric Research, 35, 127–45.Google Scholar
Bresler, S. A., Logan, W. S. and Washington, D. (2000). Hyperparathyroidism and psychosis: possible prelude to murder. Journal of Forensic Science, 45, 728–30.Google Scholar
Brown, G. G., Preisman, R. C. and Kleerekoper, M. (1987). Neurobehavioral symptoms in mild primary hyperparathyroidism: related to hypercalcemia but not improved by parathyroidectomy. Henry Ford Hospital Medical Journal, 35, 211–15.Google Scholar
Buckman, M. T. and Kellner, R. (1985). Reduction of distress in hyperprolactinemia with bromocriptine. American Journal of Psychiatry, 142, 242–4.Google Scholar
Carroll, B. J., Feinberg, M., Greden, J. F., et al. (1981). A specific laboratory test for the diagnosis of melancholia. Standardization, validation, and clinical utility. Archives of General Psychiatry, 38, 15–22.Google Scholar
Cleghorn, R. A. (1965). Surgery and the psyche. Journal of International College of Surgeons, 44, 561–6.Google Scholar
Cohen, S. I. (1980). Cushing's syndrome: a psychiatric study of 29 patients. British Journal of Psychiatry, 136, 120–4.Google Scholar
Correa, N., Opler, L. A., Kay, S. R., et al. (1987). Amantadine in the treatment of neuroendocrine side effects of neuroleptics. Journal of Clinical Psychopharmacology, 7, 91–5.Google Scholar
Deary, I. J. and Frier, B. M. (1996). Severe hypoglycaemia and cognitive impairment in diabetes. British Medical Journal, 313, 767–8.Google Scholar
Dorn, L. D., Burgess, E. S., Dubbert, B., et al. (1995). Psychopathology in patients with endogenous Cushing's syndrome: ‘atypical’ or melancholic features. Clinical Endocrinology (Oxford), 43, 433–42.Google Scholar
Eiber, R., Berlin, I., Grimaldi, A., et al. (1997). Insulin-dependent diabetes and psychiatric pathology: general clinical and epidemiologic review. Encephale, 23, 351–7.Google Scholar
Engum, A., Bjoro, T., Mykletun, A., et al. (2002). An association between depression, anxiety and thyroid function – a clinical fact or an artefact?Acta Psychiatrica Scandinavica, 106, 27–34.Google Scholar
Fava, M., Fava, G. A., Kellner, R., et al. (1982). Depression and hostility in hyperprolactinemia. Progress in Neuropsychopharmacology and Biological Psychiatry, 6, 479–82.Google Scholar
Fourman, P., Rawnsley, K., Davis, R. H., et al. (1967). Effect of calcium on mental symptoms in partial parathyroid insufficiency. Lancet, 2, 914–15.Google Scholar
Gold, P. W., Loriaux, D. L., Roy, A., et al. (1986). Responses to corticotropin-releasing hormone in the hypercortisolism of depression and Cushing's disease. Pathophysiologic and diagnostic implications. New England Journal of Medicine, 314, 1329–35.Google Scholar
Guerrieri, M., Filipponi, S., Arnaldi, G., et al. (2002). Unusual clinical manifestation of pheochromocytoma in a MEN2A patient. Journal of Endocrinological Investigation, 25, 53–7.Google Scholar
Hudson, J. I., Hudson, M. S., Griffing, G. T., et al. (1987). Phenomenology and family history of affective disorder in Cushing's disease. American Journal of Psychiatry, 144, 951–3.Google Scholar
Jalenques, I., Tauveron, I., Albuisson, E., et al. (1993). Prevalence of anxiety and depressive symptoms in patients with type 1 and 2 diabetes. Revue médicale de la Suisse romande, 113, 639–46.Google Scholar
Joborn, C., Hetta, J., Palmer, M., et al. (1986). Psychiatric symptomatology in patients with primary hyperparathyroidism. Uppsala Journal of Medical Sciences, 91, 77–87.Google Scholar
Joborn, C., Hetta, J., Rastad, J., et al. (1988). Psychiatric symptoms and cerebrospinal fluid monoamine metabolites in primary hyperparathyroidism. Biological Psychiatry, 23, 149–58.Google Scholar
Johnstone, P. A., Rundell, J. R. and Esposito, M. (1990). Mental status changes of Addison's disease. Psychosomatics, 31, 103–7.Google Scholar
Kalmijn, S., Mehta, K. M., Pols, H. A., et al. (2000). Subclinical hyperthyroidism and the risk of dementia. The Rotterdam study. Clinical Endocrinology (Oxford), 53, 733–7.Google Scholar
Kathol, R. G. (2002). Endocrine disorders. In The American Psychiatric Publishing Textbook of Consultation-liaison Psychiatry: Psychiatry in the Medically Ill, 2nd edn., ed. Wise, M. G. and Rundell, J. R.. Washington, DC: American Psychiatric Publisher, pp. 563–7.
Kathol, R. G. and Delahunt, J. W. (1986). The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria. General Hospital Psychiatry, 8, 23–8.Google Scholar
Kathol, R. G., Turner, R. and Delahunt, J. (1986). Depression and anxiety associated with hyperthyroidism: response to antithyroid therapy. Psychosomatics, 27, 501–5.Google Scholar
Kelly, W. F., Kelly, M. J. and Faragher, B. (1996). A prospective study of psychiatric and psychological aspects of Cushing's syndrome. Clinical Endocrinology (Oxford), 45, 715–20.Google Scholar
Kupka, R. W., Nolen, W. A., Post, R. M., et al. (2002). High rate of autoimmune thyroiditis in bipolar disorder: lack of association with lithium exposure. Biological Psychiatry, 51, 305–11.Google Scholar
Linder, J., Brimar, K., Granberg, P. O., et al. (1988). Characteristic changes in psychiatric symptoms, cortisol and melatonin but not prolactin in primary hyperparathyroidism. Acta Psychiatrica Scandinavica, 78, 32–40.Google Scholar
Lishman, W. A. (1998). Endocrine diseases and metabolic disorders. In Organic Psychiatry: the Psychological Consequences of Cerebral Disorder, 3rd edn. Oxford: Blackwell Science, pp. 507–69.
Lloyd, C. E., Dyer, P. H. and Barnett, A. H. (2000). Prevalence of symptoms of depression and anxiety in a diabetes clinic population. Diabetic Medicine, 17, 198–202.Google Scholar
Lobo, A., Pérez-Echeverría, M. J., Jimenez-Aznarez, A., et al. (1988). Emotional disturbances in endocrine patients. Validity of the scaled version of the General Health Questionnaire (GHQ-28). British Journal of Psychiatry, 152, 807–12.Google Scholar
Lobo, A., Huyse, F., Herzog, T., et al. (1992). Profiles of Psychiatric and Physical Co-morbidity. Paper read before the E. C. L. W. Health Service Study Conference: Amsterdam.
Maguire, G. A. (2002). Prolactin elevation with antipsychotic medications: mechanisms of action and clinical consequences. Journal of Clinical Psychiatry, 63(Suppl. 4), 56–62.Google Scholar
Martignoni, E., Costa, A., Sinforiani, E., et al. (1992). The brain as a target for adrenocortical steroids: cognitive implications. Psychoneuroendocrinology, 17, 343–54.Google Scholar
Mauri, M., Sinforiani, E., Bono, G., et al. (1993). Memory impairment in Cushing's disease. Acta Neurologica Scandinavica, 87, 52–5.Google Scholar
Mayou, R., Peveler, R., Davies, B., et al. (1991). Psychiatric morbidity in young adults with insulin-dependent diabetes mellitus. Psychological Medicine, 21, 639–45.Google Scholar
Nemeroff, C. B. (1989). Clinical significance of psychoneuroendocrinology in psychiatry: focus on the thyroid and adrenal. Journal of Clinical Psychiatry, 50(Suppl.), 13–20.Google Scholar
Oliveira, M. C., Pizarro, C. B., Golbert, L., et al. (2000). Hyperprolactinemia and psychological disturbance. Arquives de Neuropsiquiatria, 58, 671–6.Google Scholar
Oomen, H. A., Schipperijn, A. J. and Drexhage, H. A. (1996). The prevalence of affective disorder and in particular of a rapid cycling of bipolar disorder in patients with abnormal thyroid function tests. Clinical Endocrinology (Oxford), 45, 215–23.Google Scholar
Pérez-Echeverría, M. J. (1985). Correlaciones entre trastornos endocrinológicos, niveles hormonales en sangre, variables de personalidad y alteraciones psicopatológicas. Unpublished Ph.D. Thesis, Universidad de Zaragoza.
Petersen, P. (1968). Psychiatric disorders in primary hyperparathyroidism. Journal of Clinical Endocrinology and Metabolism, 28, 1491–5.Google Scholar
Pieri-Balandraud, N., Hugueny, P., Henry, J. F., et al. (2001). Hyperparathyroidism induced by lithium. A new case. Review Medicine Interne, 22, 460–4.Google Scholar
Pratty, J. S., Ananth, J. and O'Brien, J. E. (1986). Relationship between dystonia and serum calcium levels. Journal of Clinical Psychiatry, 47, 418–19.Google Scholar
Reus, I. V. (1987). Disorders of the adrenal cortex and gonads. In Handbook of Clinical Psychoneuroendocrinology, ed. Nemeroff, C. B. and Loosen, P. T.. New York: Guilford Press, pp. 71–84.
Richert, S., Strauss, A., Fahlbusch, R., et al. (1987). Psychopathologic symptoms and personality traits in patients with florid acromegaly. Schweizer Archfür Neurologic und Psychiatrie, 138, 61–86.Google Scholar
Simon, N. M., Blacker, D., Korbly, N. B., et al. (2002). Hypothyroidism and hyperthyroidism in anxiety disorders revisited: new data and literature review. Journal of Affective Disorders, 69, 209–17.Google Scholar
Sonino, N. and Fava, G. A. (2001). Psychiatric disorders associated with Cushing's syndrome. Epidemiology, pathophysiology and treatment. CNS Drugs, 15, 361–73.Google Scholar
Starkman, M. N., Schteingart, D. E. and Schork, M. A. (1981). Depressed mood and other psychiatric manifestations of Cushing's syndrome: relationship to hormone levels. Psychosomatic Medicine, 43, 3–18.Google Scholar
Starkman, M. N., Zelnik, T. C., Nesse, R. M., et al. (1985). Anxiety in patients with pheochromocytomas. Archives of Internal Medicine, 145, 248–52.Google Scholar
Starkman, M. N., Schteingart, D. E. and Schork, M. A. (1986). Cushing's syndrome after treatment: changes in cortisol and ACTH levels, and amelioration of the depressive syndrome. Psychiatry Research, 19, 177–88.Google Scholar
Starkman, M. N., Gebarski, S. S., Berent, S., et al. (1992). Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing's syndrome. Biological Psychiatry, 32, 756–65.Google Scholar
Stern, R. A., Robinson, B., Thorner, A. R., et al. (1996). A survey study of neuropsychiatric complaints in patients with Graves' disease. Journal of Neuropsychiatry and Clinical Neuroscience, 8, 181–5.Google Scholar
Trzepacz, P. T., McCue, M., Klein, I., et al. (1988). A psychiatric and neuropsychological study of patients with untreated Graves' disease. General Hospital Psychiatry, 10, 49–55.Google Scholar
White, R. E., Pickering, A. and Spathis, G. S. (1996). Mood disorder and chronic hypercalcemia. Journal Psychosomatic Research, 41, 343–7.Google Scholar
Wilkinson, G., Borsey, D. Q., Leslie, P., et al. (1998). Psychiatric morbidity and social problems in patients with insulin-dependent diabetes mellitus. British Journal of Psychiatry, 153, 38–43.Google Scholar
World Health Organization, . (1992). The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines: Geneva: World Health Organization.

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×