Cortisolism (Cushing’s syndrome) is an overproduction of glucocorticoids, accompanied by an increase in the secretion of salt corticosteroids and androgens. The main mechanism is the overproduction of ACTH, which leads to bilateral adrenocortical hyperplasia and adrenocortical tumors. Clinical manifestations】 Somatic symptoms include full moon face, facial flushing, buffalo back, abdominal purple lines, centripetal obesity, hirsutism, hypertension and female amenorrhea. More than half of the patients have psychiatric symptoms, depression is the most common, and some patients can be more severe. Common cognitive impairments include difficulty concentrating and memory loss, probably due to cortisol damage to the hippocampus. In addition, some patients experience delusions, hallucinations and depersonalization. Psychiatric symptoms caused by steroid treatment or adrenal cancer are highlighted by manic symptoms or psychotic symptoms. Psychotic symptoms usually appear within two weeks of steroid treatment and worsen with increasing steroid doses. In addition, when steroids are suddenly stopped, it can lead to depression, anorexia, emotional instability, memory impairment, delirium, and weakness. Treatment】 The principle of treatment for Cushing syndrome is to treat the primary disease first, usually the psychiatric symptoms improve with the treatment of Cushing syndrome, but the cognitive impairment takes longer to recover. Severely depressed patients may need to take antidepressants. Psychiatric disorders caused by steroid agents often disappear with the end of drug therapy, but require slow taper because it takes time for the suppressed pituitary gland to resume normal ACTH secretion. For patients who have psychotic symptoms but require continued treatment with steroid preparations, antipsychotics and lithium can help prevent or alleviate manic symptoms or psychotic symptoms.