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Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion?
CONTEXT: Cushing’s syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking. OBJECTIVE: We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the eff...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765655/ https://www.ncbi.nlm.nih.gov/pubmed/33017843 http://dx.doi.org/10.1210/clinem/dgaa695 |
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author | Morelli, Valentina Ghielmetti, Alberto Caldiroli, Alice Grassi, Silvia Siri, Francesca Marzia Caletti, Elisabetta Mucci, Francesco Aresta, Carmen Passeri, Elena Pugliese, Flavia Di Giorgio, Annabella Corbetta, Sabrina Scillitani, Alfredo Arosio, Maura Buoli, Massimiliano Chiodini, Iacopo |
author_facet | Morelli, Valentina Ghielmetti, Alberto Caldiroli, Alice Grassi, Silvia Siri, Francesca Marzia Caletti, Elisabetta Mucci, Francesco Aresta, Carmen Passeri, Elena Pugliese, Flavia Di Giorgio, Annabella Corbetta, Sabrina Scillitani, Alfredo Arosio, Maura Buoli, Massimiliano Chiodini, Iacopo |
author_sort | Morelli, Valentina |
collection | PubMed |
description | CONTEXT: Cushing’s syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking. OBJECTIVE: We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the effect of adrenalectomy on mental health. DESIGN: We enrolled 62 AI patients (64.8 ± 8.9 years) referred to our centers. Subclinical hypercortisolism was diagnosed when cortisol after 1mg-dexamethasone suppression test was >50 nmol/L, in the absence of signs of overt hypercortisolism, in 43 patients (SH+). INTERVENTIONS: The structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-5, and 5 psychiatric scales were performed. The Brief Assessment of Cognition in Schizophrenia (Verbal and Working Memory, Token and Symbol Task, Verbal Fluency, Tower of London) was explored in 26 patients (≤65 years). RESULTS: The prevalence of psychiatric disorders was 27.4% (SH+ 30.2% vs SH- 21.1%, P = 0.45). SH+ showed a higher prevalence of middle insomnia (by the Hamilton Depression Rating Scale) compared with SH- (51% vs 22%, P = 0.039). Considering the Sheehan Disability Scale, SH+ showed a higher disability score (7 vs 3, P = 0.019), higher perceived stress (4.2 ± 1.9 vs 2.9 ± 1.9, P = 0.015), and lower perceived social support (75 vs 80, P = 0.036) than SH-. High perceived stress was independently associated with SH (odds ratio [OR] = 5.46, confidence interval 95% 1.4–21.8, P = 0.016). Interestingly, SH+ performed better in verbal fluency (49.5 ± 38.9 vs 38.9 ± 9.0, P = 0.012), symbol coding (54.1 ± 6.7 vs 42.3 ± 15.5, P = 0.013), and Tower of London (15.1 vs 10.9, P = 0.009) than SH-. In 8 operated SH+, no significant changes were found. CONCLUSIONS: Subclinical hypercortisolism may influence patients’ mental health and cognitive performances, requiring an integrated treatment. |
format | Online Article Text |
id | pubmed-7765655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77656552020-12-31 Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? Morelli, Valentina Ghielmetti, Alberto Caldiroli, Alice Grassi, Silvia Siri, Francesca Marzia Caletti, Elisabetta Mucci, Francesco Aresta, Carmen Passeri, Elena Pugliese, Flavia Di Giorgio, Annabella Corbetta, Sabrina Scillitani, Alfredo Arosio, Maura Buoli, Massimiliano Chiodini, Iacopo J Clin Endocrinol Metab Clinical Research Articles CONTEXT: Cushing’s syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking. OBJECTIVE: We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the effect of adrenalectomy on mental health. DESIGN: We enrolled 62 AI patients (64.8 ± 8.9 years) referred to our centers. Subclinical hypercortisolism was diagnosed when cortisol after 1mg-dexamethasone suppression test was >50 nmol/L, in the absence of signs of overt hypercortisolism, in 43 patients (SH+). INTERVENTIONS: The structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-5, and 5 psychiatric scales were performed. The Brief Assessment of Cognition in Schizophrenia (Verbal and Working Memory, Token and Symbol Task, Verbal Fluency, Tower of London) was explored in 26 patients (≤65 years). RESULTS: The prevalence of psychiatric disorders was 27.4% (SH+ 30.2% vs SH- 21.1%, P = 0.45). SH+ showed a higher prevalence of middle insomnia (by the Hamilton Depression Rating Scale) compared with SH- (51% vs 22%, P = 0.039). Considering the Sheehan Disability Scale, SH+ showed a higher disability score (7 vs 3, P = 0.019), higher perceived stress (4.2 ± 1.9 vs 2.9 ± 1.9, P = 0.015), and lower perceived social support (75 vs 80, P = 0.036) than SH-. High perceived stress was independently associated with SH (odds ratio [OR] = 5.46, confidence interval 95% 1.4–21.8, P = 0.016). Interestingly, SH+ performed better in verbal fluency (49.5 ± 38.9 vs 38.9 ± 9.0, P = 0.012), symbol coding (54.1 ± 6.7 vs 42.3 ± 15.5, P = 0.013), and Tower of London (15.1 vs 10.9, P = 0.009) than SH-. In 8 operated SH+, no significant changes were found. CONCLUSIONS: Subclinical hypercortisolism may influence patients’ mental health and cognitive performances, requiring an integrated treatment. Oxford University Press 2020-10-05 /pmc/articles/PMC7765655/ /pubmed/33017843 http://dx.doi.org/10.1210/clinem/dgaa695 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Articles Morelli, Valentina Ghielmetti, Alberto Caldiroli, Alice Grassi, Silvia Siri, Francesca Marzia Caletti, Elisabetta Mucci, Francesco Aresta, Carmen Passeri, Elena Pugliese, Flavia Di Giorgio, Annabella Corbetta, Sabrina Scillitani, Alfredo Arosio, Maura Buoli, Massimiliano Chiodini, Iacopo Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? |
title | Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? |
title_full | Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? |
title_fullStr | Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? |
title_full_unstemmed | Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? |
title_short | Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion? |
title_sort | mental health in patients with adrenal incidentalomas: is there a relation with different degrees of cortisol secretion? |
topic | Clinical Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765655/ https://www.ncbi.nlm.nih.gov/pubmed/33017843 http://dx.doi.org/10.1210/clinem/dgaa695 |
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