Hostname: page-component-84b7d79bbc-c654p Total loading time: 0 Render date: 2024-07-27T18:34:19.420Z Has data issue: false hasContentIssue false
  • English
  • Français

The Symptoms of Depression in Endocrine Disorders

Published online by Cambridge University Press:  07 November 2014

Burton Hutto
Get access Rights & Permissions [Opens in a new window]

Abstract

Many endocrine disorders present with symptoms of depression, thus differentiating primary depressive disorders from such endocrine conditions can be challenging. Awareness of the typical clinical picture of endocrine disorders is of primary importance. This article discusses a variety of common and uncommon endocrine disorders and the symptomatology that might suggest a depressive illness, and reviews literature on how endocrinopathies can mimic depression. Emphasis is also placed on the role that stress can play in the pathogenesis of endocrine disorders. Psychiatrists should be familiar with the range of presenting symptoms for endocrine disorders, and they should not rely on the presence or absence of stressors to guide their differential diagnosis between depression and endocrine disorder.

Type
Feature Articles
Information
CNS Spectrums , Volume 4 , Issue 4: Psychiatric Aspects of Medical Illness , April 1999 , pp. 51 - 61
Copyright
Copyright © Cambridge University Press 1999

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

REFERENCES

1.Freud, S. The resistances to psychoanalysis. In: Strachey, J, ed. The Complete Psychological Works of Sigmund Freud. Vol 19. London, England: Hogarth Press; 1923:214–215.Google Scholar
2.Logotheis, J. Psychiatric behavior as the initial indicator of adult myxedema. J Nerv Ment Dis. 1963;136:561.CrossRefGoogle Scholar
3.Fava, M, Labbate, LA, Abraham, ME, Rosenbaum, JF. Hypothyroidism and hyperthyroidism in major depression revisited. J Clin Psychiatry. 1995;56:186–192.Google Scholar
4.Szabadi, E. Thyroid dysfunction and affective illness: check the hypothalamic-pituitary-thyroid axes in patients resistant to treatment. Br Med J. 1991;302:923–924.CrossRefGoogle Scholar
5.Denicoff, KD, Joffe, RT, Lakshmanan, MC, Robbins, J, Rubinow, DR. Neuropsychiatric manifestations of altered thyroid state. Am J Psychiatry. 1990;147:94–99.Google ScholarPubMed
6.Extein, IL, Gold, MS. Thyroid hormone potentiation of tricyclics. Psychosomatics. 1988;29:166–174.CrossRefGoogle ScholarPubMed
7.Tunbridge, WMG, Evered, DC, Hall, R, et al.The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol. 1977;7:481–492.CrossRefGoogle Scholar
8.Sternbach, HA, Gold, MS, Pottash, AC, Extein, I. Thyroid failure and protirelin (thyrotropin-releasing hormone) test abnormalities in depressed outpatients. JAMA. 1983;249:1618–1620.CrossRefGoogle ScholarPubMed
9.Joffe, RT, Levitt, AJ. Major depression and subclinical (grade 2) hypothyroidism. Psychoneuroendocrinology. 1992;17:215–221.CrossRefGoogle ScholarPubMed
10.Haggerty, JJ Jr, Marquardt, M, McAllister, N, Ilgen, E, Mason, G, Prange, AJ. Depressive symptomatology in medical patients with antithyroid antibodies. Biol Psychiatry. 1991;29:153A.Google Scholar
11.Haggerty, JJ Jr, Stern, RA, Mason, G, Beckwith, J, Morey, CE, Prange, AJ. Subclinical hypothyroidism: a modifiable risk factor for depression? Am J Psychiatry. 1993;150:508–510.Google ScholarPubMed
12.Baldini, IM, Vita, A, Mauri, MC. et al.Psychopathological and cognitive features in subclinical hypothyroidism. Prog Neuropsychopharmacol Biol Psychiatry. 1997;21:925–935.CrossRefGoogle ScholarPubMed
13.Haggerty, J, Silva, SG, Marquardt, ME, et al.Prevalence of antithyroid antibodies in mood disorders. Depress Anxiety. 1997;5:91–96.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
14.Lazarus, J, Hall, R, Othman, S, et al.The clinical spectrum of postpartum thyroid disease. QJM. 1996;89:429–435.CrossRefGoogle ScholarPubMed
15.Ball, S. Antenatal screening of thyroid antibodies. Lancet. 1996;348:906–907.CrossRefGoogle ScholarPubMed
16.Sonino, N, Fava, GA, Belluardo, P, Girelli, ME, Boscaro, M. Course of depression in Cushing's syndrome: response to treatment and comparison with Graves' disease. Horm Res. 1993;39:202–206.CrossRefGoogle ScholarPubMed
17.Trzepacz, PT, McCue, M, Klein, I, Levey, GS, Greenhouse, J. A psychiatric and neuropsychological study of patients with untreated Graves' disease. Gen Hosp Psychiatry. 1988;10:49–55.CrossRefGoogle ScholarPubMed
18.Harris, T, Creed, F, Brugha, TS. Stressful life events and Graves' disease. Br J Psychiatry. 1992;161:535–541.CrossRefGoogle ScholarPubMed
19.Ehrmann, DA, Weinberg, M, Sarne, DH. Limitations to the use of a sensitive assay for serum thyrotropin in the assessment of thyroid status. Arch Intern Med. 1989;149:369–372.CrossRefGoogle Scholar
20.Roca, RP, Blackman, MR, Ackerley, MB, Harman, SM, Gregerman, RI. Thyroid hormone elevations during acute psychiatric illness: relationship to severity and distinction from hyperthyroidism. Endocr Res. 1990;16:415–447.CrossRefGoogle ScholarPubMed
21.Rose, RM. Psychoendocrinology. In: Wilson, JD, Foster, DW, eds. Williams Textbook of Endocrinology. 7th ed. Philadelphia, Pa: WB Saunders; 1985:653–681.Google Scholar
22.Kelly, WF, Kelly, MJ, Faragher, B. A prospective study of psychiatric and psychological aspects of Cushing's syndrome. Clin Endocrinol. 1996;45:715–720.CrossRefGoogle ScholarPubMed
23.Sonino, N, Fava, GA. Psychosomatic aspects of Cushing's disease. Psychother Psychosom. 1998;67:140–146.CrossRefGoogle ScholarPubMed
24.Kelly, WF. Psychiatic aspects of Cushing's syndrome. QJM. 1996;89:543–551.CrossRefGoogle Scholar
25.Yanovski, JA, Cutler, GB Jr.Glucocorticoid action and the clinical features of Cushing's syndrome. Endocrinol Metab Clin North Am. 1994;23:489–509.CrossRefGoogle ScholarPubMed
26.Ross, EJ, Linch, DC. Cushing's syndrome-killing disease: discriminatory value of signs and symptoms aiding early diagnosis. Lancet. 1982;2:646–649.CrossRefGoogle ScholarPubMed
27.Pies, R. Differential diagnosis and treatment of steroid-induced affective syndromes. Gen Hosp Psychiatry. 1995;17:353–361.CrossRefGoogle ScholarPubMed
28.Nieman, LK, Loriaux, DL. Corticotropin-releasing hormone: clinical applications. Annu Rev Med. 1989;40:331–339.CrossRefGoogle ScholarPubMed
29.Sonino, N, Fava, GA, Boscaro, M. A role for life events in the pathogenesis of Cushing's disease. Clin Endocrinol. 1993;38:261–264.CrossRefGoogle ScholarPubMed
30.Gotch, PM. Cushing's syndrome from the patient's perspective. Endocrinol Metab Clin North Am. 1994;23:607–617.CrossRefGoogle ScholarPubMed
31.Dorn, LD, Burgess, ES, Dubbert, B, et al.Psychopathology in patients with endogenous Cushing's syndrome: ‘atypical’ or melancholic features. Clin Endocrinol. 1995;43:433–442.CrossRefGoogle ScholarPubMed
32.Dorn, LD, Burgess, ES, Friedman, TC, Dubbert, B, Gold, PW, Chrousos, GP. The longitudinal course of psychopathology in Cushing's syndrome after correction of hypercortisolism. J Clin Endocrinol Metab. 1997;82:912–919.Google ScholarPubMed
33.Johnstone, PA, Rundell, JR, Esposito, M. Mental status changes of Addison's disease. Psychosomatics. 1990;31:103–107.CrossRefGoogle ScholarPubMed
34.Chan, AK, Quan-Yang, D, Katz, M, Siperstein, AE, Clark, OH. Clinical manifestations of primary hyperparathyroidism before and after parathyroidectomy. Ann Surg. 1995;222:402–414.CrossRefGoogle ScholarPubMed
35.Okamoto, T, Gerstein, HC, Obara, T. Psychiatric symptoms, bone density and non-specific symptoms in patients with mild hypercalcemia due to primary hyperparathyroidism: a systematic overview of the literature. Endocr J. 1997;44:367–374.CrossRefGoogle ScholarPubMed
36.VanPeenen, HJ. Depression and hypercalcemia. Am J Med. 1996;101:111–117.Google Scholar
37.Ozatung, S, Guscott, RG, Soni, J, Steiner, M. Psychosis resulting in suicide in a patient with primary hyperthyroidism. Can J Psychiatry. 1986;31:342–343.Google Scholar
38.St. Goar, W. Gastrointestinal symptoms as a clue to the diagnosis of primary hyperparathyroidism: a review of 45 cases. Ann Intern Med. 1956;46:102.Google Scholar
39.Leigh, H, Kramer, SI. The psychiatric manifestations of endocrine disease. Adv Intern Med. 1984;29:413–445.Google ScholarPubMed
40.Lawlor, BA. Hypocalcemia, hypoparathyroidism, and organic anxiety syndrome. J Clin Psychiatry. 1988;49:317–318.Google ScholarPubMed
41.Eaton, W, Armenian, H, Gallo, J, Pratt, L, Ford, DE. Depression and risk for onset of type II diabetes. Diabetes Care. 1996;19:1097–1102.CrossRefGoogle ScholarPubMed
42.Lustman, PJ, Griffin, LS, Freedland, KE, Clouse, RE. The course of major depression in diabetes. Gen Hosp Psychiatry. 1997;19:138–143.CrossRefGoogle ScholarPubMed
43.Kohen, D, Burgess, AP, Catalan, J, Lant, A. The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus. Qual Life Res. 1998;7:197–204.CrossRefGoogle ScholarPubMed
44.Jacobson, AM. The psychological care of patients with insulin-dependent diabetes mellitus. N Engl J Med. 1996;334:1249–1253.CrossRefGoogle ScholarPubMed
45.Goodnick, PJ, Henry, JH, Buki, VMV. Treatment of depression in patients with diabetes mellitus. J Clin Psychiatry. 1995;56:128–136.Google ScholarPubMed
46.Seidman, SN, Rabkin, JG. Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression. J Affect Disord. 1998;48:157–161.CrossRefGoogle ScholarPubMed
47.Bemesderfer, S. A revised psychoanalytic view of menopause. J Am Psychoanal Assoc. 1996;44(suppl):351–369.CrossRefGoogle ScholarPubMed
48.Nicol-Smith, L. Causality, menopause, and depression: a critical review of the literature. BMJ. 1996;313:1229–1232.CrossRefGoogle ScholarPubMed
49.Pearce, J, Hawton, K, Blake, F. Psychological and sexual symptoms associated with the menopause and the effects of hormone replacement therapy. Br J Psychiatry. 1995;167:163–173.CrossRefGoogle ScholarPubMed
50.Pearlstein, TB. Hormones and depression: what are the facts about premenstrual syndrome menopause and hormone replacement therapy? Am J Obstet Gynecol. 1995;173:646–653.CrossRefGoogle ScholarPubMed
51.Hunter, MS. Depression and the menopause: depression in a middle aged woman should not automatically be blamed on the menopause. BMJ. 1996;313:1217–1218.CrossRefGoogle Scholar
52.Abed, RT, Clark, J, Elbadawy, MH, Cliffe, MJ. Psychiatric morbidity in acromegaly. Acta Psychiatr Scand. 1987;75:635–639.CrossRefGoogle ScholarPubMed
53.Furman, K, Ezzat, S. Psychological features of acromegaly. Psychother Psychosom. 1998;67:147–153.CrossRefGoogle ScholarPubMed
54.Kellner, R, Buckman, MT, Fava, GA, et al.Hyperprolactinemia distress and hostility. Am J Psychiatry. 1984;141:759–763.Google ScholarPubMed
55.Koppelman, MCS, Parry, BL, Hamilton, JA, Alagna, SW, Loriaux, L. Effect of bromocriptine on affect and libido in hyperprolactinemia. Am J Psychiatry. 1987;144:1037–1041.Google ScholarPubMed
56.Rothchild, E. Psychologic aspects of galactorrhea. J Psychosom Obstet Gynaecol. 1985;4:185–196.CrossRefGoogle Scholar
57.Reavley, S, Fisher, AD, Owen, D, Creed, FH, Davis, JRE. Psychological distress in patients with hyperprolactinaemia. Clin Endocrinol. 1997;47:343–348.CrossRefGoogle ScholarPubMed
58.Sobrinho, LG, Nunes, MCP, Calhaz-Jorge, C, Afonso, AM, Pereira, MC, Santos, MA. Hyperprolactinemia in women with paternal deprivation during childhood. Obstet Gynecol. 1984;64:465–468.Google ScholarPubMed
59.Sobrinho, LG. Emotional aspects of hyperprolactinemia. Psychother Psychosom. 1998;67:133–139.CrossRefGoogle ScholarPubMed
60.Lynch, S, Merson, S, Beshyah, SA, et al.Psychiatric morbidity in adults with hypopituitarism. J R Soc Med. 1994;87:445–447.CrossRefGoogle ScholarPubMed