title: Mania as a presentation of primary hypothyroidism.
abstract: Hypothyroidism is a common problem in clinical practice, with diverse manifestations. Neuropsychiatric problems include affective disorders, disturbances in cognition and psychosis. Mania is commonly associated with hyperthyroidism. Only a few selected case reports mention mania as a presenting feature of hypothyroidism. We report a case of mania with psychotic symptoms in a 47-year-old woman who had no previous history of psychiatric disorder. She had signs of florid hypothyroidism. She required both antipsychotic drugs and thyroxine replacement for the amelioration of her symptoms. The report is followed by a brief review of the literature on mania as a clinical presentation of hypothyroidism and its probable pathogenesis. One has to have a high index of suspicion of underlying organic causes in patients presenting with depression, psychosis or cognitive disorders.
authors.affiliation: Associates in Clinical Endocrinology, Education and Research, Geo Towers, 3rd floor, Apollo Speciality Hospital Annexe, Chennai 35, India. anjalisathyab@yahoo.co.in
authors.forename: A
authors.initials: A
authors.lastname: Sathya
authors.forename: R
authors.initials: R
authors.lastname: Radhika
authors.forename: S
authors.initials: S
authors.lastname: Mahadevan
authors.forename: Un
authors.initials: U
authors.lastname: Sriram
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018692:Antimanic Agents; D013974:Thyroxine