Short Description or Definition
Endogenous Cushing’s syndrome (CS) is a rare disorder occurring in about 0.7–2.4 per million population per year (Newell-Price, Bertagna, Grossman, & Nieman, 2006). CS includes symptoms and signs resulting from chronic supraphysiological exposure to glucocorticoids (GC). The classical clinical features of CS are centripetal obesity with abnormal fat distribution, mainly affecting the face, neck, trunk, and abdomen, and sparing the extremities. Other findings are facial plethora, easy bruisability, purple abdominal striae, hirsutism, muscle weakness, hypertension, and glucose intolerance (Stewart, 2008). In addition, mood alterations and psychiatric diseases – mainly depressive and anxiety disorders – as well as cognitive impairment are highly prevalent in CS patients (Bourdeau et al., 2005).
The principal aim of this chapter is to present psychiatric and cognitive data on adult patients with CS. The recognition of psychoneurological abnormalities...
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References and Readings
van Aken, M. O., Pereira, A. M., Biermasz, N. R., van Thiel, S. W., Hoftijzer, H. C., Smit, J. W. A., et al. (2005). Quality of life in patients after long-term biochemical cure of Cushing’s disease. The Journal of Clinical Endocrinology and Metabolism, 90, 3279–3286.
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Biller, B. M., Grossman, A. B., Stewart, P. M., et al. (2008). Treatment of adrenocorticotropin-dependent Cushing’s syndrome: A consensus statement. The Journal of Clinical Endocrinology and Metabolism, 93, 2454–2462.
Bourdeau, I., Bard, C., Forget, H., Boulanger, Y., & Cohen, H., Lacroix, A. (2005). Cognitive function and cerebral assessment in patients with Cushing’s syndrome. In J. W. Findling & H. Raff (Eds.), Cushing’s Syndrome. Endocrinology and Metabolism Clinics of North America, 32(2), 441–458.
Bourdeau, I., Bard, C., Noel, B., Leclerc, I., Cordeau, M. P., Bélair, M., et al. (2002). Loss of brain volume in endogenous Cushing’s syndrome and its reversibility after correction of hypercortisolism. The Journal of Clinical Endocrinology and Metabolism, 87, 1949–1954.
Dorn, L. D., Burgess, E. S., Dubbert, B., Simpson, S. E., Friedman, T., Kling, M., et al. (1995). Psychopathology in patients with endogenous Cushing’s syndrome: ‘Atypical’ or melancholic features. Clinical Endocrinology, 43, 433–442.
Dorn, L. D., Burgess, E. S., Friedman, T. C., Dubbert, B., Gold, P. W., & Chrousos, G. P. (1997). The longitudinal course of psychopathology in Cushing’s syndrome after correction of hypercortisolism. The Journal of Clinical Endocrinology and Metabolism, 82, 912–919.
Dorn, L. D., & Cerrone, P. (2000). Cognitive function in patients with Cushing syndrome. Clinical Nursing Research, 9, 420–440.
Forget, H., Lacroix, A., & Cohen, H. (2002). Persistent cognitive impairment following surgical treatment of Cushing’s syndrome. Psychoneuroendocrinology, 27, 367–383.
Forget, H., Lacroix, A., Somma, M., & Cohen, H. (2000). Cognitive decline in patients with Cushing’s syndrome. Journal of the International Neuropsychological Society, 6, 20–29.
Haskett, R. F. (1985). Diagnostic categorization of psychiatric disturbance in Cushing’s syndrome. The American Journal of Psychiatry, 142, 911–916.
Heald, A. H., Ghosh, S., Bray, S., Gibson, C., Anderson, S. G., Buckler, H., et al. (2004). Long-term negative impact on quality of life in patients with successfully treated Cushing’s disease. Clinical Endocrinology, 61, 458–465.
Hook, J. N., Giordani, B., Schteingart, D. E., Guire, K., Giles, J., Ryan, K., et al. (2007). Patterns of cognitive change over time and relationship to age following successful treatment of Cushing’s disease. Journal of International Neuropsychological Society, 13, 21–29.
Hudson, J. I., Hudson, M. S., Griffing, G. T., Melby, J. C., & Pope, H. G., Jr. (1987). Phenomenology and family history of affective disorder in Cushing’s disease. The American Journal of Psychiatry, 144, 951–953.
Kelly, W. F. (1996). Psychiatric aspects of Cushing’s syndrome. QJM: Monthly Journal of the Association of Physicians, 89, 543–551.
Kelly, W. F., Kelly, M. J., & Faragher, C. (1996). A prospective study of psychiatric and psychological aspects of Cushing’s syndrome. Clinical Endocrinology, 45, 715–720.
Khiat, A., Bard, C., Lacroix, A., et al. (1999). Brain metabolic alterations in Cushing’s syndrome as monitored by proton magnetic resonance spectroscopy. NMR in Biomedicine, 12, 357–363.
Lindsay, J. R., Nansel, T., Baid, S., Gumowski, J., & Nieman, L. K. (2006). Long-term impaired quality of life in Cushing’s syndrome despite initial improvement after surgical remission. The Journal of Clinical Endocrinology and Metabolism, 91, 447–453.
Loosen, P. T., Chambliss, B., DeBold, C. R., Shelton, R., & Orth, D. N. (1992). Psychiatric phenomenology in Cushing’s disease. Pharmacopsychiatry, 25, 192–198.
Mauri, M., Sinforiani, E., Bono, G., Vignati, F., Berselli, M. E., Attanasio, R., et al. (1993). Memory impairment in Cushing’s disease. Acta Neurologica Scandinavica, 87, 52–55.
McEwen, B. S., Weiss, J. M., & Schwartz, L. S. (1968). Selective retention of corticosterone by limbic structures in rat brain. Nature, 220, 911–912.
Newell-Price, J., Bertagna, X., Grossman, A. B., & Nieman, L. K. (2006). Cushing’s syndrome. Lancet, 367, 1605–1617.
Nieman, L. K., Biller, B. M., Findling, J. W., et al. (2008). The diagnosis of Cushing’s syndrome: An endocrine society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism, 93, 1526–1540.
Sonino, N., Fava, G. A., Belluardo, P., Girelli, M. E., & Boscaro, M. (1993). Course of depression in Cushing’s syndrome: Response to treatment and comparison with Graves’ disease. Hormone Research, 39, 202–206.
Sonino, N., Fava, G. A., Raffi, A. R., Boscaro, M., & Fallo, F. (1998). Clinical correlates of major depression in Cushing’s disease. Psychopathology, 31, 302–306.
Starkman, M. N., Gebarski, S. S., Berent, S., & Schteingart, D. E. (1992). Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing’s syndrome. Biological Psychiatry, 32, 756–765.
Starkman, M. N., Giordani, B., Gebarski, S. S., & Schteingart, D. E. (2006). Improvement in mood and ideation associated with increase in right caudate volume. Journal of Affective Disorders, 101, 139–147.
Starkman, M. N., Schteingart, D. E., & Schork, M. A. (1981). Depressed mood and other psychiatric manifestations of Cushing’s syndrome: Relationship to hormone levels. Psychosomatic Medicine, 43, 3–18.
Starkman, M. N., Schteingart, D. E., & Schork, M. A. (1986). Cushing’s syndrome after treatment: Changes in cortisol and ACTH levels, and amelioration of the depression syndrome. Psychiatry Research, 19, 177–188.
Stewart, P. M. (2008). The adrenal cortex. In P. R. Larsen, H. M. Kronenberg, S. Melmed, & K. S. Polonsky (Eds.), Williams textbook of endocrinology, pp. 445–503.
Whelan, T. B., Schteingart, D. E., Starkman, M. N., & Smith, A. (1980). Neuropsychological deficits in Cushing’s syndrome. The Journal of Nervous and Mental Disease, 168, 753–757.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this entry
Cite this entry
Bourdeau, I., Forget, H. (2011). Cushing’s Syndrome. In: Kreutzer, J.S., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-79948-3_548
Download citation
DOI: https://doi.org/10.1007/978-0-387-79948-3_548
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-79947-6
Online ISBN: 978-0-387-79948-3
eBook Packages: Behavioral Science