Purpose of Review <p>Psychiatric symptoms such as depression, anxiety, psychosis, and cognitive impairment frequently accompany endocrine disorders and may precede or obscure the underlying diagnosis. This review aims to synthesize current evidence on the neurobiological mechanisms linking endocrine dysfunction to psychiatric manifestations and to outline clinically relevant diagnostic and therapeutic strategies.</p> Recent Findings <p>Growing evidence highlights the central role of neuroendocrine axes, circadian dysregulation, neuroinflammation, and impaired neuroplasticity in mediating psychiatric symptoms across a wide range of endocrine conditions, including thyroid and adrenal disorders, diabetes, polycystic ovary syndrome, parathyroid diseases, hypopituitarism, and neuroendocrine tumors. Population-based studies demonstrate increased risks of depression, anxiety, and cognitive dysfunction in these conditions, while neuroimaging and molecular data reveal structural and functional brain alterations related to hormonal imbalance. Importantly, correction of the underlying endocrine disorder often leads to partial or complete resolution of psychiatric symptoms, whereas isolated psychopharmacological treatment may be insufficient.</p> Summary <p> Psychiatric manifestations of endocrine disorders represent potentially reversible neurobiological consequences of hormonal dysregulation rather than primary psychiatric disease in many cases. An endocrine-first, mechanism-informed approach—integrating targeted hormonal evaluation, cautious use of psychotropic medications, psychotherapy, and multidisciplinary care—is essential to improve diagnostic accuracy, reduce treatment resistance, and optimize long-term mental and physical health outcomes.</p>