Neuroendocrine disorders

Learning outcomes:

By the end of this module you should be able to:

 

  • describe the basic structure and function of the hypothalamic-pituitary axis and the hormones secreted by the hypothalamus and pituitary gland

     

  • identify the aetiology, clinical features and treatment of mood disorders which are related to the menstrual cycle and pregnancy and distinguish between their presentations

     

  • outline the physiological role of thyroid hormones, the control of their secretion and the causes, clinical features, investigation and treatment of thyroid disease

     

  • describe the anatomy and secretory role of the adrenal gland, control of adrenocortical hormone secretion and the aetiology, clinical features, investigation and treatment of disorders caused by their excessive and insufficient secretion

     

  • outline the function of the pineal gland and its role in sleep disorder

     

  • identify the causes of gonadal hormone disorders and clinical features of syndromes caused by gonadal dysgenesis

     

  • differentiate the aetiology of type 1 and type 2 diabetes, outline the clinical features and know the basic management of the two types

     

  • describe the mechanism of action of growth hormone and the causes, diagnosis and outcomes of growth hormone secretion deficiency.

 

Module introduction

Why is knowledge of the neuroendocrine system important for psychiatrists?

 

Endocrinology and psychiatry have a close and complex relationship. Endocrine disorders can affect a person’s mental state well before the onset of physical signs of illness; for example, depression occurs in people with hypothyroidism, and Cushing’s syndrome typically manifests with various neuropsychiatric features. Similarly, psychiatric disorders can be accompanied by abnormalities of hormonal levels, such as when blunted growth hormone response to provocative stimuli is seen in depression (Checkley et al, 1981).

 

Hormonal imbalances can be a side-effect of psychotropic drugs. For example, people receiving lithium require close monitoring of their thyroid function, and some endocrine disorders can be precipitated by stressful life events such as Cushing’s syndrome and Grave’s disease. These examples highlight the interface between neuropsychiatry and endocrinology. It is important for us as psychiatrists to have a good knowledge of the associations between endocrine disorders and psychiatric illness so that we are able to identify and manage them successfully.

 

This module will cover the neuroscience of common endocrine disorders along with their psychiatric manifestations.

 

Learning notes

We recommend that you make some notes as you work through this module.

 

The 'TrOn Notebook' facility can be accessed throughout the module (allowing you to make notes on each page), and these notes will be saved in your personal area 'My TrOn', for future reference. However, you will not be able to print these notes as one single document.

 

If you would prefer to make your notes in a separate document you may wish to download the 'learning notes' below. This downloadable Word document will allow you to keep a personalised record of your learning, which you can then save and/or print for future reference.

 

Download the learning notes document for this module

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© 2017 Royal College of Psychiatrists