Sathya A, Radhika R, Mahadevan S, Sriram Un
Associates in Clinical Endocrinology, Education and Research, Geo Towers, 3rd floor, Apollo Speciality Hospital Annexe, Chennai 35, India.
Singapore Med J. 2009 Feb;50(2):e65-7.
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.
甲状腺功能减退是临床实践中的常见问题，表现多样。神经精神问题包括情感障碍、认知障碍和精神病。躁狂症通常与甲状腺功能亢进有关。仅有少数精选病例报告提及躁狂症是甲状腺功能减退的首发特征。我们报告一例47岁女性的躁狂症伴精神病性症状，该女性既往无精神疾病史。她有明显的甲状腺功能减退体征。她需要使用抗精神病药物和甲状腺素替代治疗来改善症状。报告之后是对有关躁狂症作为甲状腺功能减退临床表现及其可能发病机制的文献的简要综述。对于出现抑郁、精神病或认知障碍的患者，必须高度怀疑潜在的器质性病因。
