{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:06:07Z","timestamp":1783983967054,"version":"3.55.0"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The potential association between mild autonomous cortisol secretion and\npsychopathological symptoms remains inadequately studied. This study aimed to\ninvestigate whether women with mild autonomous cortisol secretion exhibit\ngreater psychological symptom severity and distress compared with patients with\nnonfunctional adrenal adenomas, as assessed by multidimensional self-report\nscales including the Beck Depression Inventory-II, Beck Anxiety Inventory, and\nSymptom Checklist\u201190. A cross-sectional study was conducted at the endocrinology\ndepartment of a tertiary-care hospital in Turkey between June 2022 and 2025. The\nstudy cohort included 91 women with adrenal adenomas, comprising 50 patients\nwith mild autonomous cortisol secretion and 41 patients with nonfunctional\nadrenal adenoma. Questionnaire-derived scores from the 10 subscales and Global\nSeverity Index of the Symptom Checklist-90, as well as the Beck Anxiety\nInventory and Beck Depression Inventory-II, along with hormonal parameters,\nincluding morning cortisol, adrenocorticotropic hormone, dehydroepiandrosterone\nsulfate, 1-mg dexamethasone-suppressed cortisol, 24-hour urinary free cortisol,\nthe dehydroepiandrosterone sulfate ratio, and the\ncortisol\/dehydroepiandrosterone sulfate ratio, were compared between the groups.\nWomen with mild autonomous cortisol secretion exhibited higher overall\npsychological distress, as measured by the Global Severity Index of the Symptom\nChecklist-90. Depressive (Beck Depression Inventory-II) and anxiety (Beck\nAnxiety Inventory) symptoms did not differ significantly between groups,\nalthough a non-significant pattern suggested that depressive symptom severity\nmay increase with higher basal cortisol levels. No significant associations were\nfound between hormonal parameters and psychological scores. These findings\nindicate that patients with mild autonomous cortisol secretion may experience\nincreased general psychological distress, highlighting the importance of\nconsidering mental health in their clinical evaluation and warranting further\nresearch into the relationship between mild cortisol excess and specific\npsychiatric symptoms.<\/jats:p>","DOI":"10.1055\/a-2874-9528","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T22:37:51Z","timestamp":1780439871000},"page":"266-271","source":"Crossref","is-referenced-by-count":0,"title":["Psychiatric Symptoms in Women with Mild Autonomous Cortisol Secretion\nVersus Non-Functioning Adrenal Adenomas: A Cross-Sectional Study"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0420-2606","authenticated-orcid":false,"given":"Ilkay","family":"Cakir","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuat","family":"M\u0131s\u0131ro\u011flu","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"Elustu Belten","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didem","family":"Acarer","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8127-8543","authenticated-orcid":false,"given":"Hamide","family":"Piskinpasa","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0765-0770","authenticated-orcid":false,"given":"Seda","family":"Karsl\u0131","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Ezel","family":"Yildirim","sequence":"additional","affiliation":[{"name":"of Health Sciences, Bakirkoy Prof. Dr.\nMazhar Osman Training and Research Hospital for Psychiatric, Neurologic and\nNeurosurgical\nDiseases, Turkey","place":["Istanbul"],"department":["Department of Psychiatry,\nUniversity"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meral","family":"Mert","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-6562","authenticated-orcid":false,"given":"Sema","family":"Ciftci","sequence":"additional","affiliation":[{"name":"University of Health\nSciences, Bakirkoy Dr. Sadi Konuk Training and Research\nHospital, Turkey","place":["Istanbul"],"department":["Department of Endocrinology and\nMetabolism"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Hatipoglu","sequence":"additional","affiliation":[{"name":"University of Health Sciences, Basaksehir Cam and Sakura City\nHospital, Florya, Turkey","place":["Istanbul"],"department":["Endocrinology, Metabolism and Diabetes"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1530\/EJE-16-0467","article-title":"Management of adrenal incidentalomas: European society of endocrinology clinical\npractice guideline in collaboration with the European network for the study of\nadrenal tumors","volume":"175","author":"M Fassnacht","year":"2016","journal-title":"Eur J Endocrinol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0889-8529(05)70122-5","article-title":"Management approaches to adrenal incidentalomas. A view from rochester,\nminnesota","volume":"29","author":"W F Young","year":"2000","journal-title":"Endocrinol Metab Clin North Am"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ejendo\/lvad066","article-title":"European society of endocrinology clinical practice guidelines on the management\nof adrenal incidentalomas, in collaboration with the European network for the\nstudy of adrenal tumors","volume":"189","author":"M Fassnacht","year":"2023","journal-title":"Eur J Endocrinol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12020-019-01888-y","article-title":"Autonomous cortisol secretion in adrenal incidentalomas","volume":"64","author":"M Araujo-Castro","year":"2019","journal-title":"Endocrine"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1055\/a-0713-0598","article-title":"Adrenal incidentaloma: picking out the high-risk patients","volume":"127","author":"G D Dalmazi","year":"2019","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"4462","DOI":"10.1210\/jc.2014-3007","article-title":"Cortisol as a marker for increased mortality in patients with incidental\nadrenocortical adenomas","volume":"99","author":"M Debono","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S2213-8587(16)00086-3","article-title":"Complications of Cushing's syndrome: the state of the art","volume":"4","author":"R Pivonello","year":"2016","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/MED.0000000000000633","article-title":"Psychological complications of Cushing's syndrome","volume":"28","author":"A Santos","year":"2021","journal-title":"Curr Opin Endocrinol Diabetes 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Carafone","year":"2021","journal-title":"Biomedicines"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.eprac.2024.04.008","article-title":"Plasma steroid profiling combined with machine learning for the differential\ndiagnosis in mild autonomous cortisol secretion from nonfunctioning adenoma in\npatients with adrenal incidentalomas","volume":"30","author":"D Mu","year":"2024","journal-title":"Endocr Pract"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1199875","DOI":"10.3389\/fendo.2023.1199875","article-title":"Association between contralateral adrenal and hypothalamus-pituitary-adrenal\naxis in benign adrenocortical tumors","volume":"14","author":"Z Hongyuan","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.yfrne.2008.11.002","article-title":"Neurobiological and neuropsychiatric effects of dehydroepiandrosterone (DHEA)\nand DHEA sulfate 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Endocrinol"},{"key":"ref38","first-page":"525","article-title":"Psychiatric and sleep disorders in patients with non-functional adrenal\ntumors","volume":"19","author":"H Mirzaei","year":"2025","journal-title":"J Clin Endocrinol Metab"}],"container-title":["Hormone and Metabolic 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