Psychotic manifestation of hypothyroidism. A case report].
Haberfellner EM, et al. Nervenarzt. 1993.
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The case of a young woman is reported, who was treated one and a half years with psychopharmacologic agents and psychotherapy until hypothyroidism was diagnosed. Initially the psychopathology with prominent though disorders led to a tentative diagnosis of schizophrenia. Under administration of thyroid hormone the patient was free of psychiatric and somatic symptoms within 3 months. Problems of diagnosis, therapy and prognosis are discussed in relation of the literature.
PMID 8321343 [Indexed for MEDLINE]
Article in German.
There is little doubt that thyroid hormone plays a major role in the regulation of mood, cognition, and behavior. As a result, persons with thyroid dysfunction frequently experience a wide variety of neuropsychiatric sequelae. The range of physical and psychiatric presentations and their potential subtle manifestations make hypothyroidism a diagnosis that is easy to miss. Behavioral changes may occur in the absence of the classical physical signs and symptoms of the disorder. As a result, it is imperative to remember that many patients presenting with psychiatric disorders may have alterations in endocrine function. The endocrine dysfunction may be the cause of the presenting complaint, a factor complicating the management of an underlying illness, or a consequence of treatment. Since psychiatric complaints may be one of the earliest manifestations of hypothyroidism, they are often misdiagnosed as functional psychiatric disorders, rather than a psychiatric disorder due to a general medical condition. This confusion leads to delayed treatment and a high likelihood of increased morbidity. The frequency of misdiagnosis and mistreatment and the potential for poor prognosis point to the importance of a high degree of suspicion of thyroid dysfunction and the need for thyroid screening in psychiatric patients.