Reed K, Bland R C
Acta Psychiatr Scand. 1977 Nov;56(5):421-6. doi: 10.1111/j.1600-0447.1977.tb06682.x.
Hypothyroidism can present a wide range of psychiatric manifestations, including personality disturbance, neurotic traits and psychotic features. Psychiatric treatment techniques without recognition and correction of the endocrine root of the mental disturbance will result in a failure of treatment. However, severe hypothyroidism can exist with a poverty of classical signs and symptoms such that both internist and psychiatrist may easily overlook endocrine dysfunction as a possible etiology of the mental disorder. A case of long-standing paranoid illness whose etiology was severe myxedema with such a poverty of signs and symptoms is presented. Failure to recognize the endocrinopathy may not only produce recovery difficulties but also psychiatric and endocrine repercussions if psychotropic medications are given in such masked cases. These problems are considered with particular reference to lithium, and screening criteria to avoid this problem are discussed.
甲状腺功能减退可表现出广泛的精神症状，包括人格障碍、神经症特质和精神病性特征。若不认识并纠正精神障碍的内分泌根源而采用精神科治疗技术，将会导致治疗失败。然而，严重甲状腺功能减退可能仅有极少的典型体征和症状，以至于内科医生和精神科医生都可能轻易忽略内分泌功能障碍这一可能导致精神障碍的病因。本文报告一例病因是严重黏液性水肿且体征和症状极少的长期偏执性疾病病例。若在这类隐匿病例中给予精神药物，未能识别内分泌病不仅可能导致康复困难，还会引发精神和内分泌方面的不良反应。本文特别结合锂剂对这些问题进行了探讨，并讨论了避免此问题的筛查标准。
