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Depression: another cortisol-related comorbidity in patients with adrenal incidentalomas and (possible) autonomous cortisol secretion

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Abstract

Purpose

Hypercortisolism is associated with a high prevalence of depression and impaired health-related quality of life (QoL). According to the available literature, studies examining the depression risk in patients with adrenal incidentalomas (AI), nonfunctioning and the ones with (possible) autonomous cortisol secretion ((P)ACS) are scarce. The aim of this observational, case–control study was to screen patients with nonfunctioning adrenal incidentalomas (NAI) and the ones with (P)ACS for depression and to assess their QoL.

Methods

The total studied group consisted of 92 subjects—26 with NAI, 34 with (P)ACS and 32 age-matched healthy controls (HC). To screen for depression, we used the Beck Depression Inventory-II (BDI-II) and to assess the QoL, we used the Short-Form 36 Health Survey (SF-36).

Results

Patients with (P)ACS had significantly higher BDI-II scores and substantially lower QoL than patients with NAI or HC. Midnight cortisol level was the most significant predictor of BDI-II and SF-36 score. The receiver operating characteristic curve analysis demonstrated that a midnight cortisol value of 86.95 nmol/l had a high sensitivity (82.8%) and high specificity (80%) for detection of mild depression in patients with (P)ACS.

Conclusion

Screening for depression and QoL assessment should become an integral part of clinical evaluation in patients with (P)ACS.

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Funding

This work was supported by the Ministry of Science, Republic of Serbia (Grant number 175067).

Author information

Authors and Affiliations

  1. Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia

    A. S. Šojat, L. V. Marina, M. Ivović, A. Kendereški, M. Tančić-Gajić, Z. Arizanović & S. Vujović

  2. Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia

    B. Dunjić-Kostić, L. V. Marina, M. Ivović, A. Kendereški, A. Ćirković, M. Tančić-Gajić, S. Mihajlović & S. Vujović

  3. Clinic for Psychiatry, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia

    B. Dunjić-Kostić

  4. Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA

    N. V. Radonjić

  5. Institute of Medical Statistics and Informatics, Dr Subotica 15, 11000, Belgrade, Serbia

    A. Ćirković

  6. University Hospital Centre Dr Dragisa Misovic, Heroja Milana Tepica 1, 11000, Belgrade, Serbia

    S. Mihajlović

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  1. A. S. Šojat
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  11. S. Vujović
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Contributions

ASS: conceptualization, methodology, investigation, resources, writing—original draft, visualization; BDK: investigation, writing—review & editing; LVM: conceptualization, methodology, investigation, resources, writing—review & editing, supervision; MI: investigation, writing—review & editing; NVR: writing—review & editing; AK: writing—review & editing; AC: formal analysis, writing—review & editing; MTG: investigation; ZA: investigation; SM: investigation; SV: writing—review & editing.

Corresponding author

Correspondence to L. V. Marina.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval

The Faculty of Medicine, University of Belgrade, Ethics Committee approved the study.

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Informed consent was obtained from all individual participants included in the study.

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Šojat, A.S., Dunjić-Kostić, B., Marina, L.V. et al. Depression: another cortisol-related comorbidity in patients with adrenal incidentalomas and (possible) autonomous cortisol secretion. J Endocrinol Invest 44, 1935–1945 (2021). https://doi.org/10.1007/s40618-021-01509-4

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  • DOI: https://doi.org/10.1007/s40618-021-01509-4

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