CLINICAL CORRELATES OF MAJOR DEPRESSION IN CUSHINGS-DISEASE

Major depression is a common, life-threatening complication of Gushing 's syndrome, with no significant differences between pituitary-depende nt and -independent forms. Little is known about the clinical correlat es of depression; in particular, whether patients with Gushing's disea se and major depression show some clinical features that are distincti ve compared to those who are not depressed, The occurrence of major de pression according to DSM-IV criteria was ascertained in 162 patients with pituitary-dependent Gushing disease. Major depression occurred in 88 of the patients (54%), It was significantly associated with older age, female sex, higher pretreatment urinary cortisol levels, relative ly more severe clinical condition, and absence of pituitary adenoma. P atients with Gushing's disease and depression appeared to suffer from a more severe form of illness, both in terms of cortisol production an d clinical presentation, compared to those who were not depressed. Bec ause of these connections, the presence of depression is an important clinical feature that should not be neglected, The findings in this st udy may have implications for a better understanding of the pathophysi ological role of depression associated with medical illness.