Do adrenal incidentalomas have an impact on mental health? A comprehensive review.

This article focuses on the mental health implications of adrenal incidentalomas (AIs), which are adrenal masses often detected incidentally during imaging for unrelated conditions. AIs are frequently associated with mild autonomous cortisol secretion (MACS), a condition characterized by subtle cortisol excess without overt Cushing's syndrome, and have been linked to increased risks of hypertension, diabetes, and other comorbidities. Emerging but limited evidence suggests that both MACS and nonfunctioning adrenal incidentalomas (NFAI) may be associated with impaired mental health, including higher rates of depression, anxiety, sleep disturbances, and cognitive dysfunction, although findings are inconsistent and often limited by small sample sizes and methodological variability. The article highlights the need for larger, prospective studies with standardized assessments to clarify the relationship between AIs, cortisol secretion, and mental health outcomes, as well as to determine the potential benefits of surgical intervention.