Mania as a presentation of primary hypothyroidism.

Singapore Med J. 2009 Feb;50(2):e65-7.

Sathya A, Radhika R, Mahadevan S, Sriram U.

Associates in Clinical Endocrinology, Education and Research, Geo Towers, 3rd floor, Apollo Speciality Hospital Annexe, Chennai 35, India. anjalisathyab@yahoo.co.in

Abstract

Hypothyroidism is a common problem in clinical practice, with diverse manifestations. Neuropsychiatric problems include affective disorders, disturbances in cognition and psychosis. Mania is commonly associated with hyperthyroidism. Only a few selected case reports mention mania as a presenting feature of hypothyroidism. We report a case of mania with psychotic symptoms in a 47-year-old woman who had no previous history of psychiatric disorder. She had signs of florid hypothyroidism. She required both antipsychotic drugs and thyroxine replacement for the amelioration of her symptoms. The report is followed by a brief review of the literature on mania as a clinical presentation of hypothyroidism and its probable pathogenesis. One has to have a high index of suspicion of underlying organic causes in patients presenting with depression, psychosis or cognitive disorders.

PMID: 19296014 [PubMed - indexed for MEDLINE]

ACUTE MANIA IN THE SETTING OF SEVERE HYPOTHYROIDISM

Psychosomatics. 2005 May-Jun;46(3):259-61.

Acute mania in the setting of severe hypothyroidism.

Stowell CP, Barnhill JW.

Department of Psychiatry, New York-Presbyterian Hospital, Weill-Cornell Medical Center, 525 East 68th St., New York, NY 10021, USA. chs9017@nyp.org

Although the associations between depression and hypothyroidism and between mania and hyperthyroidism are well described, mania in the setting of hypothyroidism is unusual. The authors present the case of a patient whose acute mania appears to have been precipitated by hypothyroidism secondary to postpartum thyroiditis. This case underscores the importance of thyroid screening in patients with mood and psychotic disorders, including patients who lack the classical psychiatric features of thyroid dysfunction. Further investigation is required on the nature of the relationship between thyroid function and bipolar disorder and any implications it may have for the diagnosis and treatment of this illness.
PMID: 15883148 [PubMed - indexed for MEDLINE]