感情障害を主症状としたCushing症候群の1例

概要

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A 32-year-old woman was admitted to out hospital in June, 1985 with an affective disorder lasting for 4 years. She had been treated for depression in another hospital. The episode of depression was characterized by inability to sleep, poor concentration, loss of energy, sad affect and dismal outlook for the future. Before this depressive episode, the hypomanic episode has preceded including overactivity and distractivity. In April, 1985,the physician noticed that her face was puffy and she had a truncal obesity and stria with hypertension. Detailed endocrinological and radiographical examination revealed that her serum cortisol levels were elevated in spite of derceased levels of ACTH and there was no response of cortisol and ACTH to ovine CRF. Also 2cm diameter of tumor mass was found in left adrenal gland. She was diagnosed as Cushing's syndrome due to left adrenal adenoma. During the hospitalization, her psychiatric symptoms had developed, that is, a confusion, a presecution complex and ICU syndrome including a suicide attempt. After the total left adrenectomy, her psychiatric symptoms were rapidly decreased and abolished.It is emphasized that the physician must consider a case of Cushimg's syndrome when he treats a case of depression.
日本心身医学会の論文
1989-10-01