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Cycloid psychoses and autoimmunity: A case report of a patient with motility psychosis and Hashimoto’s thyroiditis

Published online by Cambridge University Press:  01 September 2022

M. Lages Abrantes*
Affiliation:
Hospital Prof. Doutor Fernando Fonseca, Psychiatry And Mental Health Department, Amadora, Portugal
J. Borja Santos
Affiliation:
Hospital Prof. Doutor Fernando Fonseca, Psychiatry And Mental Health Department, Amadora, Portugal
*
*Corresponding author.

Abstract

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Introduction

Psychotic episodes characterized by sudden onset of polymorphous psychotic symptoms and fast resolution have been a subject of interest of many psychiatrists throughout the History. Controversies about the diagnostic criteria and nomenclature of cycloid psychoses persist nowadays, what has hampered its study. In last years, several reports associating this disease with autoimmune pathologies have been published, revealing a possible association between them.

Objectives

To contribute to the knowledge of cycloid psychoses, reporting a case of motility psychoses and exploring its possible association with autoimmune diseases.

Methods

Case report and literature review.

Results

A 48-years-old woman presents a history of eleven admissions at the Psychiatry nursery in the last nineteen years, due to psychotic episodes. Usually, these episodes follow a default in psychopharmacological therapeutic, and are characterized by rapid onset of psychomotor agitation, with prominent nonpurpuseful exuberant movements, incoherent speech, mood oscillations and polythematic delusion. Between these decompensations, she recover her normal functioning, being medicated with lithium and an antipsychotic. During one of her admissions, at 2015, she developed fever and a stuporous state. The magnetic resonance and lumbar puncture were normal, the electroencephalogram revealed generalized lentification. Autoimmunity investigation evidenced positive antithyroid antibodies (with normal thyroid function) and the echography validated the diagnosis of Hashimoto’s thyroiditis.

Conclusions

This case report reveals a possible relationship between cycloid psychoses and Hashimoto’s thyroiditis. We need to share more knowledge to understand if it represents a comorbidity or a pathogenic process with the same etiology, what will influence the treatment of these patients.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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