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Paranoid Reaction and Underlying Thyrotoxicosis

Published online by Cambridge University Press:  29 January 2018

S. H. Kamlana  and
L. Holms
S. H. Kamlana*
Affiliation:
West Cumberland Hospital, Whitehaven, Cumbria CA28 8JG
L. Holms
Affiliation:
West Cumberland Hospital, Whitehaven, Cumbria CA28 8JG
*
Correspondence
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Extract

Woodbury (1918) described the manifestations of Graves' disease as fatigue, irritability, intolerance to heat, fine tremor, restlessness, insomnia, excitability, labile emotional disposition, nervousness, weight loss, palpitations, doubts, and fears. Similarly, Sachar (1975) included nervousness (manifested as apprehension, restlessness, and inability to concentrate), marked emotional lability, and hyperkinesis as the most common presenting symptoms. That fatigue, irritability, emotional instability, and excitability are all common features of the hyperthyroid state, as are episodes of severe and often disabling anxiety, is therefore, accepted. On the other hand, no clear picture exists concerning any fixed constellation of psychotic symptoms or progression of psychiatric disease. The psychiatric presentations vary from a delirious state to periods of hyperexcitability simulating mania that alternate with periods of exhaustion and depression. Greer & Parsons (1968) reported that some patients do. however, develop a clear schizophrenia-like picture, closely associated with the course of hyperthyroidism, with prominent paranoid symptoms and no pre-morbid history of psychosis.

Type
Brief Reports
Information
The British Journal of Psychiatry , Volume 149 , Issue 3 , September 1986 , pp. 376 - 377
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

Burch, E. A. Jr. & Messerey, T. W. (1978) Psychiatric symptoms in medical illness: hyperthyroidism revised. Psychosomatics, 19, 71–75.CrossRefGoogle Scholar
Ettigi, P. G. & Brown, G. M. (1978) Brain disorders associated with endocrine dysfunction. Psychiatric Clinics of North America, 1, 117.CrossRefGoogle Scholar
Greer, S. & Parsons, V. (1968). Schizophrenic-like psychosis in thyroid crisis. British Journal of Psychiatry, 114, 1357–1362.CrossRefGoogle Scholar
Sachar, E. (1978) Psychiatric disturbances associated with endocrine disorders. In American Handbook of Psychiatry, (eds Arieti, S. & Reiser, M.). New York: Basic Books.Google Scholar
Woodbury, M. S. (1918) The psycho-neurotic syndrome of hyperthyroidism. Journal of Nervous and Mental Diseases, 47, 401–410.CrossRefGoogle Scholar
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