Khemka D, Ali J A, Koch C A
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Exp Clin Endocrinol Diabetes. 2011 Sep;119(8):513-7. doi: 10.1055/s-0031-1277137. Epub 2011 May 6.
In the evaluation of patients presenting with altered mental function searching for underlying medical conditions is necessary. Abnormal thyroid function has long been implicated in mood changes with the classic associations of depression occurring together with hypothyroidism and of mania along with hyperthyroidism. We here report 3 patients who presented with symptoms consistent with acute manic episode diagnosed using DSM IV-TR criteria and who were found to have primary hypothyroidism biochemically. This led to a review of the literature on this phenomenon resulting in the identification of 10 reports of mania and associated thyroid profiles consistent with primary hypothyroidism. All 3 of our patients improved clinically after use of levothyroxine and psychotropic medications, consistent with the literature reports. This illustrates that thyroid function abnormalities including primary hypothyroidism should be considered and screened for when evaluating patients with acute manic episodes.
在评估出现精神功能改变的患者时，寻找潜在的医学状况是必要的。甲状腺功能异常长期以来一直与情绪变化有关，典型的关联是抑郁症与甲状腺功能减退同时出现，而躁狂症与甲状腺功能亢进同时出现。我们在此报告3例患者，他们表现出符合使用《精神疾病诊断与统计手册》第四版修订版（DSM IV-TR）标准诊断的急性躁狂发作的症状，并且生化检查发现患有原发性甲状腺功能减退。这促使我们对关于这一现象的文献进行回顾，结果发现了10篇关于躁狂症以及与原发性甲状腺功能减退相符的甲状腺检查结果的报告。我们所有3例患者在使用左甲状腺素和精神药物后临床症状均有改善，这与文献报告一致。这表明在评估急性躁狂发作患者时，应考虑并筛查包括原发性甲状腺功能减退在内的甲状腺功能异常。
