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18 - Endocrine disorders

from Part III - Working with specific units

Published online by Cambridge University Press:  10 December 2009

By
Antonio Lobo ,
M. Jesús Pérez-Echeverría  and
Antonio Campayo
Edited by
Geoffrey Lloyd  and
Elspeth Guthrie
Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
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Summary

Introduction

The relationships between endocrine disturbances and psychiatric conditions have stirred considerable interest for several reasons (Lishman 1998). Historically, several authors have speculated about the role of hormones and endocrine disorders in relation to psychiatric conditions, and attention has been devoted to the role of hormones in relation to control and feedback processes in neural structures (Carroll et al. 1981). Psychiatric syndromes have consistently been described or documented in endocrine diseases (Kathol 2002; Lishman 1998) and may pose a real clinical challenge for the liaison psychiatrist, but the evidence in the literature to support his or her intervention is limited. This chapter reviews available data in relation to the characteristics and frequency of specific psychiatric syndromes in primary endocrine disturbances; issues of diagnosis and differential diagnosis; mechanisms of production of psychiatric symptomatology; and treatment issues, including response of psychiatric syndromes to treatment of the endocrinopathy and to psychotropic medication.

Epidemiology

Some experts have suggested that the most severe psychiatric syndromes are not as prevalent as in the past, due to improvements in diagnosis and treatment of endocrine diseases (Kathol 2002). Still, a high prevalence of psychiatric disturbances has been reported in most endocrine conditions, depression and anxiety being the most common presentations (Tables 18.1 and 18.2). As expected, lifetime prevalence is even higher in several reports (Eiber et al. 1997).

Keywords

calcium levelclinical endocrinologyCushing's syndromedepressionsymptomatologyendocrine disorderhypocalcaemia
Type
Chapter
Information
Handbook of Liaison Psychiatry , pp. 432 - 453
Publisher: Cambridge University Press
Print publication year: 2007

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