The link between Cushing syndrome, children and depression


Diagnosing depression in children and adolescents isn’t easy. Too often, it’s easy to mistake for ordinary teen moodiness. It isn’t.

Major depressive disorder is a real disease that can severely impact quality of life and education in adolescents. Depression is recognized as having a biological component. The National Institutes of Mental Health estimates that around 11 percent of children have a depressive disorder before they turn 18.  Fortunately, depression responds well to treatment.

However, depression – including suicidal thoughts – can also be a symptom of other diseases. A recent study has found a potential link between Cushing syndrome, a hormonal disorder and depression in children.

A link to depression?

Researchers from the National Institute of Health’s (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development examined the records of all children and adolescents treated for Cushing syndrome at the NIH’s hospital in Maryland – a total of 149 patients. Their results, published in the journal Pediatrics, were startling.

The researchers discovered months after treatment, nine children had experienced thoughts of suicide, outbursts or anger, depression, irritability and anxiety. Of that group of children, seven had experienced their symptoms seven months after treatment. Two other children had symptoms 48 months after treatment.

“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 lead study author Constantine Stratakis, M.D., director of the NIH’s Division of Intramural Research in a press release. “Patients may not tell their doctor that they’re feeling depressed, so it’s a good idea for physicians to screen their patients proactively for depression and related conditions.”

What is Cushing syndrome?

According to the U.S. National Library of Medicine, Cushing syndrome is a disorder caused by an excess of the hormone cortisol. Commonly called the “stress hormone,” Mayo Clinic says cortisol aids the body’s functions in stressful situations. Among other things, cortisol increases the amount of substances that repair tissues and suppresses nonessential systems during periods of stress, like the digestive and reproductive systems.

However, too much cortisol exposure in the body results in Cushing syndrome. According to the Mayo Clinic, symptoms of Cushing syndrome include:

  • Weight gain and deposits of fat around the midsection, the upper back, the face and between the shoulders
  • Striae – pink or purple stretch marks on the skin around the arms, thighs and abdomen
  • Skin that bruises easily
  • Slow healing
  • Acne

Cushing syndrome can occur from a variety of causes. Certain drugs, like oral corticosteroid medications such as prednisone, can cause the syndrome. Other causes include benign tumors on the pituitary gland or adrenal cortex. Tumors that affect cortisol levels and cause Cushing syndrome can be inherited, but this is rare.

The Cushing’s Support and Research Foundation provides several links to information on pediatric Cushing’s, including growth charts for boys and girls.

White River Academy is a therapeutic boarding school for boys aged 12 to 17 in rural Utah. Our school is staffed by experts in treatment and education who work with their students to help them reach their full potential. For more information, please contact our 24/7 helpline.

About the author

Brian Moore is a staff writer and graphic designer. A 20-year veteran of the newspaper industry,  Brian enjoys music, bicycling and playing the tuba, which’s he’s done with varying degrees of success for over 25 years.

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