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Titolo:
Psychiatric disorders associated with Cushing's syndrome - Epidemiology, pathophysiology and treatment
Autore:
Sonino, N; Fava, GA;
Indirizzi:
Univ Padua, Div Endocrinol, Dept Med & Surg Sci, I-35128 Padua, Italy UnivPadua Padua Italy I-35128 Dept Med & Surg Sci, I-35128 Padua, Italy Univ Bologna, Affect Disorders Program, Dept Psychol, Bologna, Italy Univ Bologna Bologna Italy orders Program, Dept Psychol, Bologna, Italy
Titolo Testata:
CNS DRUGS
fascicolo: 5, volume: 15, anno: 2001,
pagine: 361 - 373
SICI:
1172-7047(2001)15:5<361:PDAWCS>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
STRESSFUL LIFE EVENTS; GRAVES-DISEASE; ENDOCRINE DISEASE; DIFFERENTIAL-DIAGNOSIS; PSYCHOLOGICAL-ASPECTS; SUBCLINICAL SYMPTOMS; MAJOR DEPRESSION; CORTISOL; PATHOGENESIS; PSYCHOPATHOLOGY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
84
Recensione:
Indirizzi per estratti:
Indirizzo: Sonino, N Univ Padua, Div Endocrinol, Dept Med & Surg Sci, Via Osped 105, I-35128 Padua, Italy Univ Padua Via Osped 105 Padua Italy I-35128 35128 Padua, Italy
Citazione:
N. Sonino e G.A. Fava, "Psychiatric disorders associated with Cushing's syndrome - Epidemiology, pathophysiology and treatment", CNS DRUGS, 15(5), 2001, pp. 361-373

Abstract

Gushing's syndrome is caused by a chronic excess of glucocorticoids. A number of psychiatric and psychological disturbances may be associated with the condition, regardless of its aetiology. Major depression is the most common comorbid disorder. Other psychopathological aspects of Gushing's syndrome in adults include mania, anxiety disorders and cognitive dysfunction. The presence of depression connotes a severe clinical presentation and, inpatients with hypothalamic-pituitary forms of Gushing's syndrome, is prognostically useful. Inhibitors of corticosteroid production (e.g. ketoconazole, metyrapone, aminoglutethimide), rather than antidepressant drugs, are generally successful in relieving depressive symptoms, as well as other disabling symptoms. These drugs can be used to control symptoms prior to surgical treatment of Gushing's syndrome. Long-standing hypercortisolism may cause some degree of irreversible pathological damage and induce highly individualised affective responses based an each patient's psychological assets and iiabiBties. As a result, upon normalisation of cortisol levels, treatment may still be required, and should encompass both psychotherapeutic strategies (particularly cognitive-behavioural therapies that have been found to be effective in affective disorders)and psychotropic drug treatment [antidepressants such as tricyclic agents and selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors]. In patients with severe anxiety, benzodiazepines (e.g. clonazepam in small doses) may also be helpful.

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Documento generato il 22/01/20 alle ore 09:18:07