{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:36:23Z","timestamp":1792802183661,"version":"4.5.0"},"reference-count":39,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011727","name":"Stockholm L\u00e4ns Landsting and Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011727","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>An increase of psychiatric and sleep-related disorders could be hypothesized due to mild abnormal cortisol secretion in patients with nonfunctional adrenal tumors (NFATs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the risk of psychiatric and sleep disorders in individuals with NFATs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A national retrospective register-based study was conducted on patients diagnosed with NFATs 2005-2019 and controls, followed until death or 2019. Individuals diagnosed with adrenal hormone excess or previous malignancies were excluded. Follow-up commenced after 90 days of cancer-free survival following the NFAT diagnosis. Sensitivity analyses were performed on patients with acute appendicitis and gallbladder\/biliary tract\/pancreas disorders, and 180- and 365-day cancer-free survival. The primary study outcomes were the prevalence and incidence of psychiatric and\/or sleep disorders after adjusting for sex, age, and socioeconomic factors. Secondary outcomes were psychiatric, sleep, substance abuse, mood, anxiety and stress-related, and psychotic disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 17 561 cases (60% women, median [IQR] age 65 [56-73] years) and 122 561 controls were included. Previous psychiatric and\/or sleep disorders were more prevalent in patients diagnosed with NFATs compared to controls (odds ratio [OR] 2.11; 95%\u202fCI 2.03-2.19; adjusted OR 2.06, 95%\u202fCI 1.98-2.14). During the follow-up period (5.4 years [IQR 2.4-8.6]), the incidence of psychiatric and\/or sleep disorders was higher in patients with NFATs than in controls (hazard ratio [HR] 1.92; 95%\u202fCI 1.83-2.02; adjusted HR 1.92; 95%\u202fCI 1.82-2.01). Similar increases were found in all secondary outcomes as well as in the same direction in all sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NFAT was associated with an increased risk of psychiatric and sleep disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf525","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T11:54:21Z","timestamp":1758196461000},"page":"e705-e714","source":"Crossref","is-referenced-by-count":5,"title":["Psychiatric and Sleep Disorders in Patients With Nonfunctional Adrenal Tumors"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4246-1141","authenticated-orcid":false,"given":"Hadis","family":"Mirzaei","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska 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