Many endocrinopathies are associated with impaired quality of life and psychiatric comorbidities. Personality changes are characteristic features of endocrine diseases and can even be the dominating symptom. In such circumstances, a patient will be treated for an apparent primary psychiatric condition, whereas the underlying endocrine diagnosis is delayed for month or even years. It is textbook knowledge that mania and psychosis may be found in patients with severe hyperthyroidism, whereas patients with Cushing syndrome frequently have depressive symptoms and cognitive disturbances. In pituitary diseases, the spectrum depends on the underlying hyperfunction or hypofunction: acromegalic patients often have maladaptive personality traits and higher rates of affective disorders, and patients with prolactinoma have changes in sleep pattern and cognition. Contrary to other endocrinopathies, psychiatric comorbidities in patients with primary aldosteronism have only recently become a focus of attention.
