TOPLINE:

A notable proportion of patients with Cushing syndrome (CS) experienced depression. Pain and body image disturbances were significantly associated with persistent depression, and this relationship persisted even after the achievement of biochemical remission.

METHODOLOGY:

• Researchers in Germany conducted a monocentric longitudinal cohort study to determine whether body image disturbances and pain predict persistent depression in patients with CS.
• They included 90 patients with confirmed CS (61 with Cushing disease, 8 with ectopic CS, and 21 with adrenal CS; 73% women) and 200 control participants without CS (71% women) from the German Cushing registry; patients who did not achieve biochemical remission after surgery and those with incomplete data were excluded.
• Depression was assessed using the Beck Depression Inventory II and Patient Health Questionnaire-9 scores, body image was evaluated using standardised German questionnaires, and pain intensity was assessed using the numerical analog scale.
• For a detailed analysis, 15 patients with CS who had persistent depression were compared with 10 patients with CS who did not have depression over a median follow-up duration of 4 years.

TAKEAWAY:

• At the time of the diagnosis of CS, 44% of patients had depression.
• Patients with CS who had persistent depression had higher insecurity and discomfort scores (P < .001) and lower attractiveness and self-confidence scores (P = .04) than those who did not have depression.
• Moreover, those with persistent depression had lower scores on the vital body dynamics scale (P < .001) and higher scores on the negative body perception scale (P = .020).
• Pain intensity was significantly higher in patients with persistent depression than in those without; a significant negative association was observed between pain and vital body dynamics (P < .001), whereas a positive association was observed between pain and negative body perception (P = .005).

IN PRACTICE:

"Pain and dissatisfaction with physical changes, particularly with the altered functionality of the body in daily activities, should be promptly addressed. This approach may help to prevent the manifestation of persistent depression and its associated consequences," the authors wrote.

SOURCE:

This study was led by Franziska Bednarski, Department of Medicine IV, University Hospital, LMU Munich, Endocrinology, Munich, Germany. It was published online on February 17, 2026, in the Journal of the Endocrine Society.

LIMITATIONS:

The study was conducted at a single centre and included a small number of patients for the second part of the analysis. Because of the small sample size, CS subtypes were unequally distributed between patients with and without depression, which may have introduced bias. The control group consisted of patients with obesity rather than healthy populations, potentially affecting the comparability of the findings.

DISCLOSURES:

This study did not disclose any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.