Mental disorders associated with abnormal adrenal function
Introduction
Introduction to mental disorders associated with adrenal dysfunction Psychiatric disorders associated with adrenal hypercortisolism and adrenal insufficiency with mental disorders are all mental disorders associated with adrenal dysfunction. Adrenal hypercortisolism, also known as Cushing syndrome. The accompanying mental disorder refers to mental disorders and neurological symptoms caused by excessive secretion of cortisol due to adrenaline cortical hyperfunction. Adrenalin dysfunction, also known as Addison disease. The accompanying mental disorder is mainly due to mental disorders and neurological symptoms caused by insufficient secretion of adrenocortical hormone. basic knowledge The proportion of illness: 0.0006% Susceptible people: no special people Mode of infection: non-infectious Complications: endocrine disorders, mental disorders
Cause
Causes of mental disorders associated with adrenal dysfunction
Increased secretion of corticosteroids (35%):
The psychotic disorder associated with adrenal hypercortisolism is mainly due to increased secretion of corticosteroids. Such as Cushing's syndrome due to excessive secretion of long-term cortisol hormones, as well as excessive secretion of cortisol from primary adrenal tumors, caused by excessive secretion of pituitary or non-pituitary ACTH.
(1) Adrenalin hypersecretion The depressive disease and adrenergic cortisol have similar susceptibility. The occurrence of mental disorder is caused by a decrease in blood potassium and blood chlorine during adrenaline dysfunction, causing alkalosis, hypertension, etc. Caused by.
(2) Neurotransmitter theory The pituitary-adrenalin system and catecholamine metabolism are intrinsically linked to endocrine disorders, which can lead to depression, and depressive states can cause endocrine disorders, which are mutually causal.
(3) Genetic factors and pre-existing personality characteristics may also be related to the occurrence of mental disorders.
Autoimmune factors (24%):
Atrophy caused by destruction of the adrenal gland due to immunodeficiency. Therefore, some people think it is an immune disease.
Tuberculosis infection factor (20%):
There is also a belief that adrenal insufficiency is one of the main reasons.
Other factors (15%):
It is considered to be related to bleeding, thrombosis, arteritis, fungal infection, metastases and other factors such as trauma, surgery, pregnancy, etc.
Pathogenesis:
Psychotic disorders associated with adrenal hypercortisolism are hyperadrenal hyperfunction, physical, mental and conscious disturbances caused by increased cortisol secretion, and mental disorders associated with adrenal insufficiency are mainly due to insufficient secretion of adrenal cortical hormones. The mental symptoms and disturbances of consciousness, the exact pathogenesis is still unclear.
Prevention
Prevention of mental disorders associated with adrenal dysfunction
Actively treat the primary disease and correct and restore the endocrine environment.
Complication
Complications of mental disorders associated with adrenal dysfunction Complications, endocrine disorders, mental disorders
There is no complication of this disease.
Symptom
Symptoms of mental disorders associated with adrenal dysfunction. Common symptoms, lack of cognitive ability, mental disorders, irritability, syncope, anxiety, diplopia, loss of appetite, auditory hallucinations, dizziness
1. Psychiatric disorders associated with adrenal hypercortisolism:
(1) Mental disorders:
1 Depression state: about 60% to 80% have different degrees of depressive symptoms, similar to endogenous depression, and also show anxiety depression and delusional depression.
2 personality changes: mostly with persistent emotional instability, irritability, irritability, easy sadness or crying.
3 illusion state: mostly for auditory hallucinations, illusions and illusions.
4 dementia status: often poor memory, comprehension difficulties, similar to the performance of cerebral arteriosclerosis dementia and senile dementia.
5 disturbance of consciousness: some show drowsiness.
(2) Neurological symptoms: muscle weakness or atrophy of the extremities, tremors, epileptic seizures, muscle weakness or atrophy of the extremities, tremors and seizures.
2. Adrenal cortical dysfunction accompanied by mental disorders:
(1) Mental disorders:
1 personality change: more emotional instability at the beginning of the disease, easy to provoke or cry, negative and so on.
2 Manic or Depressed State: Manic state is characterized by euphoria, optimism, etc., but Lenovo runs, words increase and psychomotor excitement are not obvious; depression is characterized by depression, sadness, bitterness, etc., but no association is slow, spirit Exercise inhibition.
3 Illusion or delusion state: multiple cycles occur.
4 endocrine mental syndrome: that is, intended to reduce, emotional agitation, libido, loss of appetite, irritability, irregular menstruation and so on.
5 dementia status: a small number of cases can occur, mainly based on mental retardation, it was pointed out that it is a comprehensive dementia.
6 disturbance of consciousness: from lethargy, lethargy, paralysis, confusion to coma, and some sudden, more in the adrenal crisis.
(2) Neurological symptoms: vision loss, diplopia, seizures, dizziness, syncope and headache.
Examine
Examination of mental disorders associated with adrenal dysfunction
Laboratory changes consistent with the primary disease (adrenal hyperfunction, hypothyroidism).
The changes in EEG during adrenal insufficiency are mainly due to the slowing of rhythm, the decrease of amplitude, and the diffuse prefrontal dominant wave and rhythm, high amplitude fast wave, etc. This universal slow wave brain Electrograms, similar to hypoglycemia, hepatic encephalopathy, and EEG changes in cerebral hypoxia, are EEG waveforms with reduced metabolic activity in the general central nervous system.
Diagnosis
Diagnosis and diagnosis of mental disorders associated with adrenal dysfunction
diagnosis
1. There is evidence of adrenal cortical lesions.
2. There are symptoms, signs and laboratory tests for adrenal dysfunction.
3. Psychiatric symptoms change with the development of physical symptoms.
4. It should be differentiated from other endocrine dysfunction accompanied by mental disorders and other functional psychosis such as schizophrenia, snoring and depression.
Differential diagnosis
Should be associated with other endocrine dysfunction associated with mental disorders and other functional psychosis such as schizophrenia, snoring and depression.
