Fibromyalgia (FM), a chronic disabling disorder causing diffuse musculoskeletal pain, presents strong comorbidity with psychopathological disorders, including post-traumatic stress disorder (PTSD). We report the case of a 35-year old Syrian Refugee, diagnosed with both Fibromyalgia and PTSD related to traumatic events (killed husband, expulsion from home, rape with death threats, difficult socio-economic situation). An antidepressant treatment combined with psychotherapeutic and psycho-educational intervention led to satisfactory improvements. Considering the clinical case and other related studies, it seems that early management of the traumatic dimension is essential, in order to prevent the chronicity of the suffering and the emergence of psychiatric comorbidities.

Thyroid hormones are important for the development, maturation, and function of the central nervous system. While the association between the lack of thyroid hormones in congenital hypothyroidism and profound mental retardation is well documented (Dugbartey 1998), hypothyroidism acquired in adulthood can also manifest itself in a variety of symptoms not only somatic, but also psychiatric especially mood disorders, and anxiety. Psychotic symptoms are rare but are part of this psychic picture. We report the case of a 50-year-old female patient admitted to the psychiatric emergency department for psychomotor agitation of a psychotic appearance, revealing autoimmune hypothyroidism. This observation underlines the need not to underestimate the responsibility of the thyroid hormonal balance in the onset of psychotic manifestations, and to eliminate dysthyroidism before any psychotropic treatment.