Psychosomatic aspects of Cushing's disease.

The past decades have witnessed an increasing understanding of the psychosomatic aspects of Cushing's disease. Stressful life events were found to precede its onset in controlled studies. Major depression is a common, life-threatening complication of Cushing's syndrome, regardless of its etiology. The presence of depression connotes severity of clinical presentation and entails prognostic value (patients with hypothalamic-pituitary forms are more likely to relapse after successful treatment if they presented with depression). Quality of life of patients with Cushing's disease is seriously compromised. Recovery has a natural course to run and may be considerably influenced by affective responses based on highly individualized psychological assets and liabilities. The psychobiological correlates of Cushing's disease have considerable etiological, clinical and therapeutic implications. Such implications also extend over the nonendocrine forms of major depression.