Psychiatric Manifestations in Endocrine Disorders

Abstract

Tfluctuations and their relationship to human behav iour i s ca l l ed as Psychoneuroendocrinology. A number of psychiatric symptoms are seen to be associated with multiple endocrine disorders. These may be a direct result of either hyperor hypo secretion of the hormones from the endocrine glands. At times, many psychiatric or neurological conditions affect the hypothalamus or the pituitary gland and interfere with the physiological endocrine functions. Often common endocrine disorders present with psychiatric symptoms and may be mistaken for primary psychiatric disorders. An interdisciplinary team comprising of a physician, an endocrinologist, a gynaecologist, a urologist, and also a psychiatrist, is required to help identify, diagnose and treat the comorbid psychiatric symptoms to help achieve the best possible outcome and an improved quality of life for the patients. Adrenal Glands H y p e r c o r t i s o l a e m i a o r Hypocortisolaemia may be a result of a centra l cause , increased ACTH production, or a local cause at the level of the adrenal glands. The relationship between the Hypothalamic Pituitary Adrenal (HPA) axis and mood disorders is complex. Glucocorticoids can be both anabolic and catabolic in nature. They are stress hormones that prepare an individual for the demands placed by a stressful environment and create a fight or flight response. Depression is related to hyperactivity of the HPA axis. However, depressive disorders are seen in both hyper and hypocortisolaemic states. 1. Cushing's Syndrome Major Depressive Disorder (MDD), Panic Disorder and Generalised Anxiety Disorder (GAD) are seen in over 50% of cases of both the pituitary dependent and the pituitary independent form of