Sharma Akanksha, Sawant Neena, Shah Nalini
Department of Psychiatry, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
Indian J Endocrinol Metab. 2018 Jul-Aug;22(4):445-450. doi: 10.4103/ijem.IJEM_94_18.
Cushing's disease (CD) is a rare endocrine disorder associated with increased serum levels of cortisol secreted due to an underlying tumour in pituitary. Psychiatric disturbances like depression, psychosis, mania along with body image disturbances are seen in patients of CD. Hence, we undertook this research to find the prevalence and type of psychiatric disorders, body image disturbances, and self-esteem in patients of CD.
Thirty-five patients diagnosed as CD as per the standard criteria by the endocrinologist were recruited after informed consent and ethics approval. Proforma with demographic details, Structured Clinical Interview for DSM-IV, Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale, and Body Image Concern Inventory were used for assessment of the aims.
65% patients had psychopathology with 21% patients having major depressive disorder, 62% patients had mild, and 28% had moderate depression on BDI. 50% patients had body image disturbances and 60% had low self-esteem. Depression was found to have a negative correlation with self-esteem and positive correlation with body image disturbances.
A high prevalence of psychopathology is seen in patients of CD which may often go undetected. Liaison with the endocrinologist would also work towards improving the issues of body image disturbances and self-esteem for better prognosis for the patient.
库欣病（CD）是一种罕见的内分泌疾病，与垂体潜在肿瘤导致血清皮质醇水平升高有关。CD患者会出现如抑郁、精神病、躁狂等精神障碍以及身体形象障碍。因此，我们开展了这项研究，以确定CD患者精神障碍的患病率和类型、身体形象障碍及自尊情况。
在内分泌科医生按照标准标准诊断为CD的35例患者获得知情同意并通过伦理批准后纳入研究。使用包含人口统计学细节的表格、DSM-IV结构化临床访谈、贝克抑郁量表（BDI）、罗森伯格自尊量表和身体形象关注量表对研究目的进行评估。
65%的患者存在精神病理学问题，21%的患者患有重度抑郁症，62%的患者BDI评分为轻度抑郁，28%为中度抑郁。50%的患者存在身体形象障碍，60%的患者自尊水平较低。发现抑郁与自尊呈负相关，与身体形象障碍呈正相关。
CD患者中精神病理学问题的患病率较高，且往往未被发现。与内分泌科医生协作也有助于改善身体形象障碍和自尊问题，从而使患者获得更好的预后。
