RT Journal Article SR Electronic T1 Cushing’s disease presenting with psychosis JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP 351 OP 353 DO 10.1136/practneurol-2021-002974 VO 21 IS 4 A1 Mubarak Mohamed, Ahmed Saeed A1 Iqbal, Ahmed A1 Prasad, Suveera A1 Hoggard, Nigel A1 Blackburn, Daniel YR 2021 UL http://pn.bmj.com/content/21/4/351.abstract AB Cushing’s disease is a rare endocrine condition in which a pituitary corticotroph adenoma drives excess adrenal cortisol production, and is one cause of endogenous Cushing’s syndrome. We present a young woman with 3 weeks of headaches and cognitive disturbance who subsequently developed florid psychosis requiring multiple admissions under neurology and psychiatry. Her clinical stigmata of hypercortisolism and biochemical abnormalities prompted an MR scan of the pituitary, which confirmed a pituitary microadenoma. Treatment with metyrapone and subsequent surgery led to complete recovery within 2 months. Cushing’s disease commonly causes neuropsychiatric symptoms and can present with psychosis. Diagnosing Cushing’s disease can be challenging, but with early diagnosis and treatment it has an excellent prognosis.