Depression and anxiety associated with hyperthyroidism: Response to antithyroid therapy

Kathol, Roger G.; Turner, Rick; DeLaHunt, John

doi:10.1016/s0033-3182(86)72656-x

Cited by 76 publications

(39 citation statements)

References 13 publications

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“…We suggest that thyrotoxicosis should be added to the list of metabolic causes of acute mania. Although major depression in thyrotoxicosis is uncommon, one study of consecutive hyperthyroid patients showed that almost one third fulfilled Diagnostic and Statistical Manual of Mental Disorders, edn 3 -Revised (DSM-IIIR) criteria for depression (11). None of our depressed patients could be described as suffering from 'apathetic thyrotoxicosis' and they would more aptly be described…”

Section: Discussionmentioning

confidence: 75%

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

Brownlie

Rae²,

Walshe³

et al. 2000

European Journal of Endocrinology

118

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Objective: To report a series of newly diagnosed thyrotoxic patients with concurrent acute psychosis, and to assess the association between the two disorders. Design: Retrospective study of thyrotoxic patients with associated psychosis ('thyrotoxic psychosis'; TP) requiring inpatient psychiatric care. New Zealand thyrotoxicosis annual incidence figures and first psychiatric admission rates for affective psychosis were utilised to statistically assess the co-occurrence of thyrotoxicosis and affective psychosis. Patients and Methods: During the 20-year study period, 18 inpatients (16 women and 2 men), mean age 54 years, with TP were identified. No patient had a past history of thyrotoxicosis, but four had required psychiatric inpatient care many years earlier. Thyrotoxicosis was documented by radioimmunoassay of thyroid hormone levels, and thyroid scintiscan. Psychiatric manifestations were classified using ICD9 criteria. Results: Thyroid hormone levels were markedly elevated in more than half of our TP patients. All younger patients had Graves' disease, and most older patients toxic nodular goitre. All patients were treated with antithyroid drugs, and all but one subsequently received 131 I therapy. Two patients were not mentally ill when thyrotoxicosis was diagnosed, but suffered major mood swings when thyroid hormone levels were falling. There was no specific psychiatric clinical picture but affective psychoses were commonest -seven depression, seven mania. The other diagnoses were two schizophreniform, one paranoid, and one delirium. Initially, neuroleptic medication was used in all but one patient, and during long-term follow-up (median 11 years) more than half our series had remained well with no further psychiatric problems. Statistical analysis was restricted to thyrotoxic patients with first psychiatric hospital admission for affective psychosis. During the 20-year period, there were nine thyrotoxic patients (95% confidence interval 4.5-17.1) with concurrent affective psychosis requiring first admission, and the calculated expected number was only 0.36. These findings indicate a clear association well above chance co-occurrence. Conclusion: TP is not a specific clinical picture, but affective psychoses are commonest. Statistical analysis of thyrotoxic patients with concurrent affective psychoses showed an incidence well above chance co-occurrence. It appears that thyrotoxicosis may be a precipitant of acute affective psychosis.

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Section: Discussionmentioning

confidence: 75%

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

Brownlie

Rae²,

Walshe³

et al. 2000

European Journal of Endocrinology

118

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“…However, the precise mechanisms responsible remain unknown. The amelioration of thyrotoxicosis has been shown to be most effective in treating CNS manifestations [116,117]; however, there is insufficient evidence to support other specific treatments. In a small clinical study, mental symptoms such as anxiety and depression in thyrotoxicosis were significantly improved by beta-AAs [116].…”

Section: Treatment Of Central Nervous System Manifestations Of Thyroimentioning

confidence: 99%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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“…[108] Medical comorbidity. Certain medical conditions have demonstrated an association with anxiety disorders and anxiety symptoms, such as gastrointestinal problems, [109] hyperthyroidism, [110] and diabetes. [111] Studies suggest that between 80 and 86% adults 65 and older have at least one chronic medical condition.…”

Section: Comorbidity and Differential Diagnosismentioning

confidence: 99%

Anxiety disorders in older adults: a comprehensive review

Wolitzky-Taylor¹,

Castriotta²,

Lenze³

et al. 2010

Depress. Anxiety

601

398

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This review aims to address issues unique to older adults with anxiety disorders in order to inform potential changes in the DSM-V. Prevalence and symptom expression of anxiety disorders in late life, as well as risk factors, comorbidity, cognitive decline, age of onset, and treatment efficacy for older adults are reviewed. Overall, the current literature suggests: (a) anxiety disorders are common among older age individuals, but less common than in younger adults; (b) overlap exists between anxiety symptoms of younger and older adults, although there are some differences as well as limitations to the assessment of symptoms among older adults; (c) anxiety disorders are highly comorbid with depression in older adults; (d) anxiety disorders are highly comorbid with a number of medical illnesses; (e) associations between cognitive decline and anxiety have been observed; (f) late age of onset is infrequent; and (g) both pharmacotherapy and CBT have demonstrated efficacy for older adults with anxiety. The implications of these findings are discussed and recommendations for the DSM-V are provided, including extending the text section on age-specific features of anxiety disorders in late life and providing information about the complexities of diagnosing anxiety disorders in older adults. Depression and Anxiety 27:190-211, 2010.

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Depression and anxiety associated with hyperthyroidism: Response to antithyroid therapy

Cited by 76 publications

References 13 publications

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

Anxiety disorders in older adults: a comprehensive review

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