{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:43:20Z","timestamp":1793234600551,"version":"4.5.0"},"reference-count":45,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Cushing\u2019s syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the effect of adrenalectomy on mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We enrolled 62 AI patients (64.8\u2005\u00b1\u20058.9 years) referred to our centers. Subclinical hypercortisolism was diagnosed when cortisol after 1mg-dexamethasone suppression test was\u2005&amp;gt;50 nmol\/L, in the absence of signs of overt hypercortisolism, in 43 patients (SH+).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>The structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-5, and 5 psychiatric scales were performed. The Brief Assessment of Cognition in Schizophrenia (Verbal and Working Memory, Token and Symbol Task, Verbal Fluency, Tower of London) was explored in 26 patients (\u226465 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of psychiatric disorders was 27.4% (SH+\u200530.2% vs SH- 21.1%, P\u2005=\u20050.45). SH+\u2005showed a higher prevalence of middle insomnia (by the Hamilton Depression Rating Scale) compared with SH- (51% vs 22%, P\u2005=\u20050.039). Considering the Sheehan Disability Scale, SH+\u2005showed a higher disability score (7 vs 3, P\u2005=\u20050.019), higher perceived stress (4.2\u2005\u00b1\u20051.9 vs 2.9\u2005\u00b1\u20051.9, P\u2005=\u20050.015), and lower perceived social support (75 vs 80, P\u2005=\u20050.036) than SH-. High perceived stress was independently associated with SH (odds ratio [OR]\u2005=\u20055.46, confidence interval 95% 1.4\u201321.8, P\u2005=\u20050.016). Interestingly, SH+\u2005performed better in verbal fluency (49.5\u2005\u00b1\u200538.9 vs 38.9\u2005\u00b1\u20059.0, P\u2005=\u20050.012), symbol coding (54.1\u2005\u00b1\u20056.7 vs 42.3\u2005\u00b1\u200515.5, P\u2005=\u20050.013), and Tower of London (15.1 vs 10.9, P\u2005=\u20050.009) than SH-. In 8 operated SH+,\u2005no significant changes were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subclinical hypercortisolism may influence patients\u2019 mental health and cognitive performances, requiring an integrated treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa695","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T19:08:57Z","timestamp":1601924937000},"page":"e130-e139","source":"Crossref","is-referenced-by-count":40,"title":["Mental Health in Patients With Adrenal Incidentalomas: Is There a Relation With Different Degrees of Cortisol Secretion?"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6716-3045","authenticated-orcid":false,"given":"Valentina","family":"Morelli","sequence":"first","affiliation":[{"name":"Endocrinology Unit, Fondazione IRCCS 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Passeri","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabella","family":"Di Giorgio","sequence":"additional","affiliation":[{"name":"Liaison Psychiatric Service, Unit of Neurology, Department of Emergency and Critical Areas, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Corbetta","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetology Service, IRCCS Istituto 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