The complex relationship between endocrine and psychiatric disorders: an epidemiological study of risk estimates

Psychiatric comorbidities are frequently observed in patients with endocrine disorders, yet in Romania the extent and nature of this association remains underexplored in clinical settings. This study aims to evaluate the prevalence and characteristics of endocrine disorders, like Cushing's syndrome, Addison's disease, hypo- and hyperthyroidism, in patients diagnosed with depressive, anxious, and manic disorders.

We conducted a retrospective cross-sectional study using records from the Hipocrate/H3 electronic medical system between January 1, 2020, and September 1, 2024. Patients with ICD-10-coded endocrine diagnoses were identified, and the presence of documented psychiatric diagnoses was assessed. Odds ratios with 95% confidence intervals and chi-square tests were used to compare the odds of psychiatric comorbidity across endocrine diagnostic groups.

The statistical analysis revealed that patients with Addison's disease, Cushing's syndrome and hypothyroidism were associated with significantly higher odds of psychiatric comorbidity (p < 0.0001). In contrast, in the case of patients with hyperthyroidism, we observed significantly lower odds of psychiatric disorders (p < 0.0001).

The study demonstrates that psychiatric comorbidities are common among patients with endocrine disorders, underscoring a meaningful relationship between endocrine dysfunction and mental health. Because the study was cross-sectional and based on clinical records, causal interpretation is not possible. The findings support the need for integrated endocrine and psychiatric assessment in patients with selected endocrine disorders.