BIPOLAR DISORDER AND CUSHING SYNDROME: CLINICAL EVALUATION OF THE ASSOCIATION

Abstract

Bipolar Disorder and Cushing's Syndrome are psychiatric and endocrinological conditions, respectively, that significantly impact the quality of life of those affected. Bipolar Disorder is characterized by extreme changes in mood, ranging from episodes of mania to episodes of depression, while Cushing's Syndrome results from a prolonged excess of cortisol in the body, leading to a series of physical and psychological symptoms. Both conditions present significant diagnostic and treatment challenges due to their complexity and interrelationships with other medical and psychiatric conditions. Objective of the systematic review: To examine recent literature to investigate the relationship between Bipolar Disorder and Cushing's Syndrome, identifying possible associations, underlying mechanisms, and implications for diagnosis and treatment. Methodology: The review was conducted following PRISMA guidelines. Searches were carried out in the PubMed, Scielo and Web of Science databases, using the descriptors: "Bipolar Disorder", "Cushing's Syndrome", "association", "mechanisms" and "treatment". The inclusion criteria were: studies published in the last 10 years, in English or Portuguese, that investigated the relationship between Bipolar Disorder and Cushing's Syndrome in humans. Exclusion criteria were: animal studies, systematic reviews and studies with samples comorbid with other serious medical conditions. Results: The analysis of the studies identified a significant association between Bipolar Disorder and Cushing's Syndrome, suggesting possible common pathophysiological mechanisms, such as dysfunction of the hypothalamic-pituitary-adrenal axis and chronic inflammation. Furthermore, implications for the differential diagnosis and clinical management of these conditions were discussed. Conclusion: This review highlights the importance of carefully evaluating patients with Bipolar Disorder for the presence of symptoms suggestive of Cushing's Syndrome and vice versa. Understanding the underlying mechanisms may lead to more effective therapeutic approaches and improve clinical outcomes for these patients.