Myxedema Madness – Systematic literature review of published case reports

Myxedema Psychosis: Diagnostic Challenges and Management Strategies in Hypothyroidism-Induced Psychosis

“…A recent systematic review [ 14 ] revealed the multifaceted etiology of hypothyroidism. In particular, among cases with identified causes, primary hypothyroidism emerged as the most common diagnosis, representing 48% of the total.…”

Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report

“…The term “myxedematous madness” was first described in 1949 by Richard Asher [ 3 ], who reviewed 14 cases of hypothyroidism associated with acute psychosis. Subsequently, even though a number of cases with myxedema psychosis have been continuously reported [ 4 , 5 ], hypothyroidism is still one of the most common missed causes of organic psychosis [ 6 , 7 ]. It might be caused by a lack of specific characteristics of psychotic symptoms, diagnostic criteria, correlation with the severity of hypothyroidism, and different responses to thyroid hormone supplement, thereby making the thyroid function test a routine laboratory investigation in patients with psychosis [ 7 ].…”

“…Interestingly, the classic signs and symptoms of hypothyroidism may not present in patients with myxedema madness [ 5 ]. In terms of imaging investigations, white matter changes in the frontal lobe on a brain magnetic resonance imaging [ 4 ] and a generalized decrease in cerebral blood flow on single-photon emission computed tomography studies [ 11 , 12 ] have also been reported. Gupta et al [ 13 ] also revealed a reversible decrease in overall wave activity on the electroencephalogram in a patient with suspected myxedema psychosis.…”

Association between thyroid function and psychotic symptoms in adolescents with major depressive disorder: A large sample sized cross-sectional study in China

“…A recent review suggested strong evidence of abnormality in the HPT axis in schizophrenia patients, characterized by psychotic symptoms such as delusion and hallucination [ 25 ]. A 1983 review, a 2021 systematic literature review of published case reports [ 26 ], along with an Expert Opinion [ 27 ] suggest that both hypothyroidism and hyperthyroidism were associated with psychosis [ 28 ]. Ozten et al reported that a Turkish woman exhibited delusional parasitosis after being diagnosed with hyperthyroidism, and the severity of delusion fluctuated depending on her thyroid function during protracted period of follow-up [ 29 ].…”