Darko D F, Krull A, Dickinson M, Gillin J C, Risch S C
Veterans Administration Medical Center, San Diego, California.
Int J Psychiatry Med. 1988;18(3):263-70. doi: 10.2190/y6ym-9f5w-d24l-34ak.
A patient with presumed chronic paranoid schizophrenia had chronic thyroiditis and Grade I hypothyroidism. Psychosis cleared following treatment with thyroid replacement. The probable presence of two axis II disorders may have contributed to the missed medical diagnosis and the patient's eventual suicide. The personality disorders were a major problem in the patient's medical and psychiatric care. The differential diagnosis among hypothyroidism and primary axis I psychotic and depressive psychopathology has always been problematic. When axis II pathology is also present, the diagnostic dilemma is increased.
一名疑似患有慢性偏执型精神分裂症的患者同时患有慢性甲状腺炎和I级甲状腺功能减退症。甲状腺替代治疗后精神病症状得以缓解。可能存在的两种轴II障碍可能导致了漏诊以及患者最终自杀。人格障碍是该患者医疗和精神护理中的一个主要问题。甲状腺功能减退症与原发性轴I精神病性及抑郁性精神病理学之间的鉴别诊断一直存在问题。当轴II病理学情况也存在时，诊断困境会加剧。
