Abstract. Cushing syndrome is defined as a prolonged exposure to high levels of glucocorticoids. It rarely presents with mania, hypomania or psychosis. We present a case of a 48-year-old patient with severe manic episode with psycho c symptoms who was admitted to the Psychiatry Department. He was treated with aripiprazole and valproic acid with good effect. Due to hypokalemia the patient required further endocrinological diagnostics. The laboratory tests showed hypercortisolemia and elevated levels of adrenocorticotropic hormone. A diagnosis of Cushing disease was made. A pituitary tumor was suspected and the patient underwent surgery. Three months after the surgery the patient’s metabolic parameters improved and the psychiatric symptoms resolved. A manic episode or other psychiatric con di on can be the first manifestation of Cushing syndrome. A possible association between psychiatric clinical presentation and soma c diseases should not be neglected.

Key words: Cushing syndrome, psychosis, mania, psychotic symptoms

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