![]() ![]() A major depressive syndrome is seen in 50%–70% of the cases. Depression is the most prevalent psychiatric disturbance in Cushing’s syndrome. The rates for each of these symptoms vary widely across studies. The clinical features of Cushing’s syndrome can also be typical of other common disorders such as the metabolic syndrome, with insulin resistance, and polycystic ovary syndrome.ĭepression, mood dysregulation, sleep disturbance and cognitive abnormalities are also observed in Cushing’s syndrome. The non-psychiatric clinical features of Cushing’s syndrome can include central adiposity, proximal myopathy, thin skin, purple striae on the trunk, scalp hair loss, fatigue, hypertension, glucose intolerance, acne, hirsutism and menstrual irregularity. Hyper-vigilance is necessary because patients can present with features that can be nonspecific and insidious in development, and the disease activity can vary over time. ![]() ACTH independent causes are from unilateral adrenocortical tumours, which can be benign or malignant, or bilateral adrenal hyperplasia. ![]() ACTH dependent causes include, most commonly, a pituitary corticotrophic adenoma (Cushing’s disease), less frequently, an extra-pituitary tumour (ectopic ACTH syndrome) and rarely a tumour secreting corticotropin-releasing hormone (CRH). It may be adrenocorticotropic hormone (ACTH) dependent (80%–85%) or independent (15%–20%). Endogenous Cushing’s syndrome results from chronic excess glucocorticoid production from the adrenal glands. ![]()
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