Psychiatric Manifestations of Thyroid Disease

Authors: Alan N. Peiris, MD (London), MRCP (UK), Emmy Oh, MD, Sergio Diaz, MD


The connection between the thyroid gland and mental disorders has been recognized since at least the 19th century when Parry and Graves described behavioral changes linked to hyperthyroidism. While links between hypothyroidism and mental illness were described earlier, it was Richard Asher's astute observations on myxedema madness and its treatment1 that focused much needed clinical attention on this area. While no uniform consensus for thyroid disease screening exists, many clinicians have traditionally tested thyroid function in patients with mental illness. The prevalence of abnormal thyroid function tests is higher in hospitalized patients with acute psychiatric illness. However, disorders such as euthyroid sick syndrome and certain medications may contribute to these abnormalities in thyroid function.

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