{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:20:23Z","timestamp":1784312423576,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Adrenal crises (AC) occur in middle aged adults with adrenal insufficiency (AI). Psychosocial difficulties may impede effective self\u2010management in some cases. This study aimed to investigate associations between psychosocial problems and hospital admissions for AI\/AC in middle aged adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Patients<\/jats:title><jats:p>Data on all hospitalisations among patients aged 30\u201359 years with a diagnosis of AI were extracted from a regional database for the years 2005\u20132020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Trends in hospitalisations and associations between admissions and comorbid psychosocial problems were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 3948 admissions for AI between 2005 and 2020, 63.4% were in women. Admissions increased by 91.4%, from 61.89 to 118.44\/million (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), while AC admission rates increased by 176.5% (from 7.71 to 21.33\/million, p=NS). Secondary AI (SAI) admissions rose by 133.0%, from 27.98\/million to 65.20\/million (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Admissions increased in women in each decade but only in males aged 50\u201359 years. Comorbid infection was identified in 28.1% of admissions and at least one comorbid contributory psychological problem was found in 25.6%. Males, patients with SAI and those not living in a domestic partnership had a higher combined psychosocial problem burden. Females admitted with at least one sign of an AC had significantly higher psychosocial problem scores than those with less severe presentations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results suggest that psychosocial factors may play a role in some admissions for AI\/AC in adults aged between 30 and 59 years, possibly contributing to the otherwise unexplained rise in hospitalisations for AI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15166","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T09:40:00Z","timestamp":1731663600000},"page":"245-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adrenal Crisis and Adrenal Insufficiency Admissions in Patients 30\u201359 Years: Contribution of Psychosocial Factors"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6270-747X","authenticated-orcid":false,"given":"R. Louise","family":"Rushworth","sequence":"first","affiliation":[{"name":"School of Medicine Sydney The University of Notre Dame, Australia Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-6987","authenticated-orcid":false,"given":"Henrik","family":"Falhammar","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Department of Endocrinology Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5069-0981","authenticated-orcid":false,"given":"David J.","family":"Torpy","sequence":"additional","affiliation":[{"name":"Endocrine and Metabolic Unit Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Medicine The University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00136-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1807486"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3191"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/js.2019-00263"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1395680"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvad017"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-14-79"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-00208"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0685"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac175"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-017-1457-4"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2022.2023009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-023-00929-x"},{"key":"e_1_2_8_15_1","volume-title":"International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD\u201010\u2010AM) and Australian Classification of Health Interventions (ACHI), Australian Coding Standards (ACS)","author":"National Centre for Classification in Health","year":"2006"},{"key":"e_1_2_8_16_1","unstructured":"https:\/\/www.cherel.org.au\/datasets."},{"key":"e_1_2_8_17_1","unstructured":"https:\/\/www.abs.gov.au\/statistics\/people\/population\/national-state-and-territory-population\/latest-release#data-downloads-data-cubes."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-020-01379-2"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1252577"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1279"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3491"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2019.e01783"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab096"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30122-4"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.15166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T10:57:45Z","timestamp":1738580265000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.15166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,15]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/cen.15166"],"URL":"https:\/\/doi.org\/10.1111\/cen.15166","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,15]]},"assertion":[{"value":"2024-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}