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    An Acute Psychosis Revealing Hyperthyroidism: A Case Report

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    IJAR JOURNAL
    Psychiatric presentations may be a discovery circumstance for hyperthyroidism, but may also delay the diagnosis. The occurrence of psychotic disorders is rarely described during the course of hyperthyroidism. The link between these two conditions remains unclear. We report in this study a clinical case of psychotic disorders induced by hyperthyroidism.

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    An Acute Psychosis Revealing Hyperthyroidism: A Case Report

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    IJAR JOURNAL
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    Psychiatric presentations may be a discovery circumstance for hyperthyroidism, but may also delay the diagnosis. The occurrence of psychotic disorders is rarely described during the course of hyperthyroidism. The link between these two conditions remains unclear. We report in this study a clinical case of psychotic disorders induced by hyperthyroidism.

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    AN ACUTE PSYCHOSIS REVEALING HYPERTHYROIDISM: A CASE REPORT

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    Psychiatric presentations may be a discovery circumstance for hyperthyroidism, but may also delay the diagnosis. The occurrence of psychotic disorders is rarely described during the course of hyperthyroidism. The link between these two conditions remains unclear. We report in this study a clinical case of psychotic disorders induced by hyperthyroidism.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    16 views2 pages

    An Acute Psychosis Revealing Hyperthyroidism: A Case Report

    Uploaded by

    IJAR JOURNAL
    Psychiatric presentations may be a discovery circumstance for hyperthyroidism, but may also delay the diagnosis. The occurrence of psychotic disorders is rarely described during the course of hyperthyroidism. The link between these two conditions remains unclear. We report in this study a clinical case of psychotic disorders induced by hyperthyroidism.

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    © All Rights Reserved
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    of 2

    ISSN: 2320-5407 Int. J. Adv. Res.

    11(04), 638-639

    Journal Homepage: - www.journalijar.com

    Article DOI: 10.21474/IJAR01/16704


    DOI URL: http://dx.doi.org/10.21474/IJAR01/16704

    RESEARCH ARTICLE
    AN ACUTE PSYCHOSIS REVEALING HYPERTHYROIDISM: A CASE REPORT

    Soumia Ettanani, Khaoula Belerhrib and Fatiha Manoudi


    Research Team for Mental Health, Psychiatric Hospital Ibn Nafis, Marrakech, Morocco.
    ……………………………………………………………………………………………………....
    Manuscript Info Abstract
    ……………………. ………………………………………………………………
    Manuscript History Psychiatric presentations may be a discovery circumstance for
    Received: 20 February 2023 hyperthyroidism, but may also delay the diagnosis. The occurrence of
    Final Accepted: 24 March 2023 psychotic disorders is rarely described during the course of
    Published: April 2023 hyperthyroidism. The link between these two conditions remains
    unclear. We report in this study a clinical case of psychotic disorders
    Key words:-
    Hyperthyroidism, Psychiatric induced by hyperthyroidism.
    Manifestations, Acute Psychosis,
    Dysthyroidism
    Copy Right, IJAR, 2023,. All rights reserved.
    ……………………………………………………………………………………………………....
    Introduction:-
    Hyperthyroidism is a common disease due to an hyperactive functioning of the thyroid gland. Its prevalence in the
    general population varies between 0.5% and 2%, with a slight female predominance. The correlation between
    thyroid disease and psychiatric symptoms is well established. Psychotic symptoms in hyperthyroidism have been
    reported in very rare cases and they occur in less than 1% of patients with hyperthyroidism [1-2].

    Screening for psychiatric disorders of organic origin is a crucial concern for the psychiatrist. In daily practice,
    psychiatrists are often encountered with mental disorders with unusual symptoms. These symptoms might be caused
    by a systemic physical condition. Inability to recognise these pathologies may lead to a lack of proper management
    and effective treatment [3]. The aim of this study is to discuss,through a clinical case, the psychotic disorders
    induced by hyperthyroidism.

    Case Report
    A 40-year-old female patient of low socioeconomic status presented with a history of a goitre that had never been
    treated for several years. Two months before her admission to the psychiatric emergency department, the patient
    developed behavioural disorders such as recurrent psycho-motor agitation with aggression and verbalization of
    incoherent statements, delirium of bewitchment and filiation with a persecutory state. She was assessed in the
    somatic emergency department by means of a brain CT scan, a blood ionogram, a blood count, and an infectious,
    renal and liver check-up, all of which showed no abnormalities, while the thyroid check-up revealed a low TSHus
    level along with increased levels of thyroid hormones FT3 and FT4. The ultrasound revealed a multinodular thyroid
    goitre. The patient was hospitalised, received the anxiolytic lorazepam 7.5 mg/dl, the antipsychotic Olanzapine 5
    mg/dl, and carbimazole-based antithyroid treatment. The course was characterized by an improvement of the
    delusional symptoms and the patient remains stable during follow-up.

    Discussion:-
    Functional impairments of the thyroid are often associated with cognitive and psychiatric disorders [4-5]. Cognitive
    decline, dysphoria and depression are common manifestations of obvious hypothyroidism, whereas hyperthyroidism
    can cause agitation, acute psychosis and apathy, especially in old people [6]. The occurrence of mental disorders,

    638
    Corresponding Author:- Soumia Ettanani
    Address:- Research Team for Mental Health, Psychiatric Hospital Ibn Nafis, Marrakech,
    Morocco.
    ISSN: 2320-5407 Int. J. Adv. Res. 11(04), 638-639

    particularly mood disorders, during thyroid disease has been known for over a century. Similarly, psychological
    manifestations may contribute to the discovery of various endocrine diseases, such as hyperthyroidism [7].
    Delusional psychotic manifestations in hyperthyroidism have been reported in rare cases. The gravity of the
    hyperthyroidism, its duration, the chronological link between the disorders and the rapid regression of the psychotic
    symptoms under antithyroid treatment are the main arguments for a thyroid source. Most cases reported in the
    literature had mainly Graves' disease or multinodular goitre. The severity of the psychiatric symptoms often reflects
    the severity of the hyperthyroidism. In most cases, these conditions are curable and have a good prognosis [8-9-10-
    11]. The underlying mechanisms of these psychotic symptoms are not yet well understood, but a large number of
    thyroid hormone receptors are located in the brain, particularly in the limbic system. These receptors affect many
    functions including behaviour, mood and long-term memory. It seems that excessive thyroid hormones affect the
    activity of neurotransmitters such as serotonin and dopamine in this region of the brain, which may be the reason
    behind the neuropsychiatric manifestations observed during hyperthyroidism [12-13].

    Conclusion:-
    The association between hyperthyroidism and psychosis is still poorly described in the literature, however, the few
    cases reported highlight the complexity of the interactions between thyroid hormones and neurotransmitters as well
    as the importance of early detection and treatment of thyroid disease.

    Conflict of interest
    The authors declare that they have no conflicts of interest in relation to this article.

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