OP-037 : Hypocortisolism is frequently overlooked and misdiagnosed as psychiatric or other disorders

Author(s): 
Sergey Surkov1, Sergey Surkov2, Iballa Castro1 1Institut Català de la Salut, ABS Camps Blancs, Sant Boi de Llobregat (Barcelona), SPAIN 2Optima Salud, Barcelona, SPAIN
Text: 
Hormonal inbalances are presented in many patients of all ages but widely overlooked if presented initially as psychic complaints. Patients with a variety of psychiatric disorders including addictions were found to have signs and symptoms of mild to moderate hypocortisolism that seems to be commonly misdiagnosed clinical condition if we make a review of the literature. Cortisol plays a key role in physical and mental well-being and serves as the barometer of the hypothalamic-pituitary-adrenal axis (HPA), which regulates and controls responses to stress. Modern way of life continuously maintains all of us under stressful situations so many family doctors should managed with considerable pool of patients with depressions, post-traumatic stress disorder (PTSD), addictions, all are conditions with evidence of HPA dysregulation. Low cortisol may be one of several maintaining factors in the illness but once hypocortisolism has developed it may itself lead to all that symptoms of PTSD or depression and represent an important maintaining factor in illness chronicity. Patients with mild to moderate cortisol insufficiency are for the most part relegated to receiving a psychiatric diagnosis when, in fact, the hormonal disorder is represented. Many emotional symptoms of hypocortisolism are tagged as psychiatric disorders. When the presented primary symptoms fit the diagnosis of depression doctors are urged to treat these patients with antidepressants and if patients responds to that treatment it reduces even more chances to diagnose an underlying hormonal inbalances that can be treated. There are strong suggestions that hypocortisolism may be of clinical relevance and an appropriate comprehensive examination should be made in order to correctly diagnose it specially in cases of psychiatric disorders. By correcting underlying cortisol or other hormonal impairments, many patients improved, with some patients having a total reversal of psychiatric symptoms. It's reasonable to evaluate and treat hormonal insufficiencies prior to psychotropic medication.
Keywords: Cortisol, misdiagnosis, stress