Children with Cushing syndrome — a metabolic disorder caused by high levels of the stress hormone hormone cortisol — may be at higher risk for suicide as well as for depression, anxiety and other mental health conditions long after their disease has been successfully treated, says a study.
Cushing’s syndrome may be caused by tumours of the adrenal glands or other parts of the body that produce excess cortisol. It also may be caused by a pituitary tumour that stimulates the adrenal glands to produce high cortisol levels.
Treatment usually involves stopping excess cortisol production by removing the tumour. Long-term complications of the syndrome include obesity, diabetes, bone fractures, high blood pressure, kidney stones and serious infections.
“Our results indicate that physicians who care for young people with Cushing syndrome should screen their patients for depression-related mental illness after the underlying disease has been successfully treated,” said the study’s senior author Constantine Stratakis NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, US National Institutes of Health (NIH).
“Patients may not tell their doctors that they’re feeling depressed, so it’s a good idea for physicians to screen their patients proactively for depression and related conditions,” Stratakis said.
Cushing syndrome may affect both adults and children.
For the study, the researchers reviewed the case histories of all children and youth treated for Cushing syndrome at NIH from 2003 to 2014, a total of 149 patients.
The researchers found that, months after treatment, nine children (roughly six percent) had thoughts of suicide and experienced outbursts of anger and rage, depression, irritability and anxiety. Of these, seven experienced symptoms within seven months of their treatment.
Two others began experiencing symptoms at least 48 months after treatment.
The authors noted that children with Cushing syndrome often develop compulsive behaviours and tend to become over-achievers in school. After treatment, however, they then become depressed and anxious.
This is in direct contrast to adults with Cushing syndrome, who tend to become depressed and anxious before treatment and gradually overcome these symptoms after treatment, the study said.