A Rare Presentation of Catatonia due to Primary Adrenal Insufficiency

Abstract

Primary adrenal insufficiency (PAI), also called Addison’s disease, is an endocrine disorder in which the adrenal glands are unable to produce an adequate amount of glucocorticoids and/or mineralcorticoids. Acute adrenal insufficiency can present with neuropsychiatric symptoms including depression, anxiety, cognitive complaints, and changes in mental status progressing from decreased responsiveness to stupor and coma(1). It has been estimated that the prevalence of neuropsychiatric symptoms in PAI ranges from 64-84%. Though there are no case reports in the recent literature, catatonia has been associated with PAI in historical case reports(2). Therefore, PAI as a cause of catatonia may be under-recognized by psychiatrists and endocrinologists. As PAI can be potentially life threatening, it is important for the consultation-liaison psychiatrist to be able to recognize the condition in the context of vague, nonspecific neuropsychiatric complaints. Here, we present a case of catatonia presenting secondary to PAI and review the literature of neuropsychiatric symptoms associated with PAI.