Hyperthyroidism and Psychotic Symptoms: a Case Report

Abstract

IntroductionHyperthyroidism may lead to high anxiety status, emotional lability, irritability, overactivity, exaggerated sensitivity to noise, and fluctuating mood, insomnia and hyporexia. in extreme cases, they may appear delusions and hallucinations as psychiatric symptoms.Case reportwe report the case of a 53-year-old female who was diagnosed of hyperthyroidism and generalized anxiety disorder. The patient went to emergency department because of high levels of anxiety, with heart palpitations, trembling, shortness of breath and nausea. She was presenting auditory hallucinations and delusions as psychiatric symptoms. an urgent thyroid profile was made and it was observed the next results: TSH < 0.005; T4:4; T3:21. Due to a severe thyroid malfunction, the patient was admitted and treated with antithyroid agent, improving the psychiatric and somatic symptoms.Discussionin this case, a patient diagnosed of hyperthyroidism and generalized anxiety disorder presented very severe psychiatric symptoms, with hallucinations and delusions. These symptoms may be produced by primary psychiatric disorders, but is very important to look for thyroid alterations, because if they are the cause, the acute treatment of thyroid malfunction is the correct management of the patient.ConclusionsHyperthyroidism is very common in general population, being infradiagnosed most of times. in patient with anxiety or other psychiatric symptoms, it is very important to make a thyroid function tests before the diagnosis of a psychiatric disorder. in extreme cases, hyperthyroidism status may lead to severe psychiatric and somatic complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Risk Factors and Clinical Manifestations in Hyperthyroidism: Case Report

“…Previous studies have also shown that all three treatment methods (anti-thyroid medications, radioactive iodine, and surgery) show good results on the long-term quality of life of patients 28 . In some cases, anti-thyroid medication is most commonly given in patients with toxic adenoma, psychosis, fetal hyperthyroidism, fetal goiter, autoimmune, thyroid eye disease, and anxiety disorders 2,9,10,13,16,18 . Anti-thyroid medications that are widely used in the findings of the cases discussed are methimazole with varying doses of 0.5mg to 30mg/kg/day.…”

“…It is important to consider case findings in pregnant women with fetal hyperthyroidism or fetal goiter 3,11 . Hyperthyroidism occurs in 1-5% of neonates born to mothers with a history of Graves' disease 18 . Treatment with anti-thyroid medications such as methimazole or carbimazole is able to cross the placenta, which aims to maintain normal maternal and fetal thyroid function.…”