Psychiatric complications of Cushing's syndrome include irritability, anxiety, depressed mood, and cognitive impairment. Psychosis is a rare manifestation of Cushing's syndrome; therefore, the literature on the subject is limited and consists mainly of clinical case reports. We report a case of Cushing's syndrome misdiagnosed as schizophrenia-like psychosis for more than 10 years. Transsphenoidal adenomectomy resulted in amelioration of psychiatric symptoms as well as improvement of cognitive ability. Clinicians should consider the presence of psychiatric symptoms predating the diagnosis of Cushing's syndrome, especially when these symptoms are persistent and treatment-resistant, as seen in the present case.
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