Consideration of psychological distress in long term endocrine conditions is of vital importance given the prevalence of anxiety and depression in such disorders. Poor mental health can lead to compromised self-care, higher utilisation of health services, lower rates of adherence, reduced quality of life and ultimately poorer outcomes. Adjuvant psychological therapy offers an effective resource to reduce distress in endocrinological disorders. While the vast majority of work in this area has focused on psychological screening and intervention in diabetes, identification and recognition of psychological distress is equally important in other endocrinological conditions, with supportive evidence in Polycystic Ovary Syndrome and Addison's disease. Referral pathways and recommendations set out by UK guidelines and the Department of Health mandate requires greater attention across a wider range of long term endocrine disorders to facilitate improved quality of life and health outcome.