Psychoses Associated with Thyrotoxicosis

Bursten, Ben

doi:10.1001/archpsyc.1961.01710090053007

Cited by 62 publications

(25 citation statements)

References 22 publications

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“…Note that this patient had myxoedema disease is occasionally associated with acute psychosis, as shown by at least nine case reports and Brownlie’s survey in New Zealand (Brownlie et al 2000): three patients have recovered after surgical treatment (Bursten 1961; Lazarus and Jaffe 1986; Abbasi et al 2009), and others after treatment with propylthiouracil (Øestergaard Jensen 1950) or propranolol (Lee et al 1991). Although occasional cases had manic features (Bursten 1961; Stowell and Barnhill 2005), a wide variety of other psychotic syndromes have been seen.…”

Section: Thyrotoxicosismentioning

confidence: 77%

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Non-reproductive triggers of postpartum psychosis

Brockington

2016

Arch Womens Ment Health

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Bipolar disorders, and other psychoses, are known to be triggered by a number of agents apart from the reproductive process. In some women, pregnant or recently delivered, psychosis may be due to these alternative triggers. There are substantial numbers of mothers suffering from childbearing psychoses, who have been prescribed bromocriptine or steroids, have had surgical operations or developed thyrotoxicosis. It is best to eliminate these episodes and cases from study samples of puerperal psychosis.

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Section: Thyrotoxicosismentioning

confidence: 77%

“…Although occasional cases had manic features (Bursten 1961; Stowell and Barnhill 2005), a wide variety of other psychotic syndromes have been seen.…”

Section: Thyrotoxicosismentioning

confidence: 99%

Non-reproductive triggers of postpartum psychosis

Brockington

2016

Arch Womens Ment Health

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“…More recent case reports have emphasised depressive (4), manic (5), paranoid (6) and schizophreniform features (3). Psychotic reactions associated with hyperthyroidism are uncommon and accurate incidence figures are not available (7). In some papers, the psychiatric illness has not been concurrent with thyrotoxicosis, and in earlier accounts documentation of hyperthyroidism has been suboptimal.…”

Section: Introductionmentioning

confidence: 99%

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

117

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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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“…Subjects with thyroid diseases and a positive family history of mood disorders [10,11] have also been reported as suffering from mania and hypomania, depression, obsessive compulsive symptoms and organic mental disorders, such as delirium [12,13].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Psychiatric Disorders in Thyroid Diseased Patients

Placidi¹,

Boldrini²,

Patronelli³

et al. 1998

Neuropsychobiology

105

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Several studies have underlined the high prevalence of psychiatric symptoms and disorders in thyroid diseases. The aim of this study was to evaluate the prevalence of psychiatric disorders in 93 inpatients affected by different thyroid diseases during their lifetimes, by means of a standardized instrument, i.e., the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-III-Revised, Upjohn Version (SCID-UP-R). The results showed higher rates of panic disorder, simple phobia, obsessive-compulsive disorder, major depressive disorder, bipolar disorder and cyclothymia in thyroid patients than in the general population. These findings would suggest that the co-occurrence of psychiatric and thyroid diseases may be the result of common biochemical abnormalities.

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Psychoses Associated with Thyrotoxicosis

Cited by 62 publications

References 22 publications

Non-reproductive triggers of postpartum psychosis

Non-reproductive triggers of postpartum psychosis

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

Prevalence of Psychiatric Disorders in Thyroid Diseased Patients

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