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Cushing's syndrome, tryptophan and depression
The British Journal of Psychiatry : the Journal of Mental Science
|February 1, 1980
Summary
Patients with active Cushing's syndrome show higher depression scores and slightly lower total tryptophan levels compared to treated patients and those with other pituitary tumors. These findings highlight the psychiatric impact of active Cushing's syndrome.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Biochemistry
Background:
- Cushing's syndrome is a complex endocrine disorder with significant psychiatric manifestations.
- Depression is a common comorbidity in patients with Cushing's syndrome.
- Tryptophan metabolism is implicated in mood regulation and may be altered in endocrine disorders.
Purpose of the Study:
- To compare the prevalence and severity of depression in patients with active Cushing's syndrome versus successfully treated patients and those with other pituitary tumors.
- To investigate potential biochemical correlates, specifically plasma tryptophan concentrations, associated with depression in active Cushing's syndrome.
Main Methods:
- Comparative study involving three groups: active Cushing's syndrome (n=15), treated Cushing's syndrome (n=15), and other pituitary tumors (n=13).
- Psychiatric diagnoses were assessed using the CATEGO program following Present State Examinations.
- Depression severity was quantified using Hamilton Rating Scales.
- Plasma concentrations of total and free tryptophan were measured.
Main Results:
- Depression was the primary psychiatric diagnosis in the active Cushing's syndrome group.
- Patients with active Cushing's syndrome exhibited significantly higher depression scores (Hamilton Rating Scores) compared to both the treated Cushing's syndrome and other pituitary tumor groups.
- Plasma total tryptophan concentrations were slightly lower in active Cushing's syndrome patients compared to controls, but free tryptophan levels showed no significant difference.
Conclusions:
- Active Cushing's syndrome is strongly associated with significant depressive symptoms.
- While total tryptophan levels may be slightly reduced, the lack of change in free tryptophan suggests complex mechanisms underlying depression in this condition.
- Further research is warranted to elucidate the neurobiological pathways linking Cushing's syndrome, tryptophan metabolism, and depression.