A Case of Psychosis in a Patient with Secondary Adrenal Insufficiency: A Possible Etiological Role of a Hypocortisolemic-induced Increase in Proinflammatory Cytokines.

David R Spiegel, Aaron B Nelson, David C Lieb, Alexander M Pattison, Justin Smith, Patrice Zigrossi, Erin Godbout

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In one paragraph

Article in Innovations in clinical neuroscience. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it

0cells of the map it votes in

2citing papers in PubMed

–field-weighted citation impact, top 68% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

Diagnostic and Therapeutic Implications of Organic Delusional Disorder due to Tuberculous Adrenalitis.Case reports in psychiatry · 2022
Article
Acute Psychosis and Panhypopituitarism: A Case Report.The Brown journal of hospital medicine · 2022
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

David R SpiegelDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

Aaron B NelsonDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

David C LiebDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

Alexander M PattisonDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

Justin SmithDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

Patrice ZigrossiDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

Erin GodboutDr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.

Eastern Virginia Medical School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adrenal insufficiency is divided into three types based on the etiology of its development. In primary adrenal insufficiency, pathology resides in end-organ failure at the level of the adrenal cortex, while in secondary and tertiary adrenal insufficiency, impairment rests in the pituitary gland and hypothalamus, respectively. Regardless of etiology, adrenal insufficiency results in a hypocortisolemic condition. While the relationship between neuropsychiatric symptoms, especially psychosis, and hypercortisolemia has been extensively documented, the development of hypocortisolemia-induced psychosis is less common. We present a case of secondary adrenal insufficiency caused by a pituitary tumor. During the course of evaluation and treatment, the patient developed a psychotic episode. We will briefly review the condition of adrenal insufficiency and propose how hypocortisolemia can result in psychosis.

Indexed as

hypocortisolemiaproinflammatory cytokinesPsychosissecondary adrenal insufficiency

Identifiers

PMID29344425

PMCPMC5749956

OpenAlexW2988661013

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.