Children with Cushing syndrome may have higher suicide risk
March 29, 2016 - 11:07 PM
Children with Cushing syndrome 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, according to a study
by researchers at the National Institutes of Health.
results from high levels of the hormone cortisol. Long-term
complications of the syndrome include obesity, diabetes, bone fractures,
high blood pressure, kidney stones and serious infections. Cushing’s
syndrome may be caused by tumors of the adrenal glands or other parts of
the body that produce excess cortisol. It also may be caused by a
pituitary tumor that stimulates the adrenal glands to produce high
cortisol levels. Treatment usually involves stopping excess cortisol
production by removing the tumor.
“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, M.D.,
director of the Division of Intramural Research at NIH’s Eunice Kennedy Shriver
National Institute of Child Health and Human Development. “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.”
Cushing syndrome may affect both adults and children. A recent study estimated that in the United States, there are eight cases of Cushing syndrome per 1 million people per year.
The researchers published their findings in the journal Pediatrics.
They 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 6
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 behaviors 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 authors stated that health care providers might try to prepare
children with Cushing syndrome before they undergo treatment, letting
them know that their mood may change after surgery and may not improve
for months or years. Similarly, providers should consider screening
their patients periodically for suicide risk in the years following
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