{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T17:49:54Z","timestamp":1763747394988},"reference-count":10,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Psychiatry"],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p>We describe a case of severe psychotic disorder as the only manifestation of primary adrenal insufficiency. A 63-year-old man presented with psychotic symptoms without any prior psychiatric history. During the clinical and laboratorial investigation, exams revealed a normovolemic hyponatremia. The patient showed no other clinical signs or symptoms compatible with adrenal insufficiency but displayed very high ACTH and low serum cortisol concentrations. Brain magnetic resonance imaging showed no significant changes, including the pituitary gland. The patient was initially treated with intravenous corticosteroids, resulting in rapid remission of the psychotic symptoms. The association between adrenal insufficiency and neuropsychiatric symptoms is rare but these symptoms can often be the first clinical presentation of the disease.<\/jats:p>","DOI":"10.1155\/2015\/512430","type":"journal-article","created":{"date-parts":[[2015,4,12]],"date-time":"2015-04-12T17:01:00Z","timestamp":1428858060000},"page":"1-4","source":"Crossref","is-referenced-by-count":9,"title":["Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency"],"prefix":"10.1155","volume":"2015","author":[{"given":"Julia de Lima","family":"Farah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Villar","family":"Lauand","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Chequi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Pasqualino","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Henrique","family":"Bignotto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael Loch","family":"Batista","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (USP), Institute of Psychiatry, Dr. Ovidio Pires de Campos, 785-1 Andar, Ala Sul, Sala Chefias M\u00e9dicas, 05403-010 S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Aprahamian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine of Jundia\u00ed, Jundia\u00ed, Brazil"},{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (USP), Institute of Psychiatry, Dr. Ovidio Pires de Campos, 785-1 Andar, Ala Sul, Sala Chefias M\u00e9dicas, 05403-010 S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(13)61684-0"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1590\/s0004-27302004000500019"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2002.t01-1-01552.x"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-1368"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(05)66700-1"},{"issue":"4","key":"6","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1176\/jnp.2006.18.4.450","volume":"18","year":"2006","journal-title":"The Journal of Neuropsychiatry & Clinical Neurosciences"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2006.01.003"},{"issue":"5","key":"8","first-page":"312","volume":"61","year":"1990","journal-title":"Der Nervenarzt"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2012.12.017"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1523\/jneurosci.0086-04.2004"}],"container-title":["Case Reports in Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crips\/2015\/512430.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crips\/2015\/512430.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crips\/2015\/512430.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,23]],"date-time":"2017-06-23T05:15:59Z","timestamp":1498194959000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/crips\/2015\/512430\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015]]},"references-count":10,"alternative-id":["512430","512430"],"URL":"https:\/\/doi.org\/10.1155\/2015\/512430","relation":{},"ISSN":["2090-682X","2090-6838"],"issn-type":[{"value":"2090-682X","type":"print"},{"value":"2090-6838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015]]}}}