title: Where does her mood come from? An organic approach to a once functional patient.
abstract: OBJECTIVE
  To report the rare development of manic symptoms in a patient with schizophrenia and discuss its differential diagnosis.
  
  
  METHODS
  Diagnostic criteria were based on the International Classification of Diseases, 10th edition (ICD-10). A 63-year-old female (diagnosed with schizophrenia since she was 28) was brought to the emergency room with symptoms consistent with manic episode and physical examination suggestive of thyrotoxicosis. Graves' disease was confirmed by subsequent laboratory tests. She was treated successfully with radioiodine ablation, leading to full remission of manic symptoms.
  
  
  CONCLUSIONS
  Schizophrenia is a chronic disease that affects about 1% of the population worldwide. The main symptoms of the disorder are altered affection, delusions, and hallucinations. Graves' disease is an autoimmune condition in which antibodies increase the production and release of thyroid hormones. There are reports about the development of mood symptoms in patients with Graves' disease that remit with adequate treatment.
authors.affiliation: Department of Psychiatry, Centro Psiquiátrico do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Pablo Eduardo Pereira
authors.initials: PE
authors.lastname: Dutra
authors.affiliation: Department of Psychiatry, Centro Psiquiátrico do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Wagner de Sousa
authors.initials: Wde S
authors.lastname: Gurgel
authors.affiliation: Department of Psychiatry, Centro Psiquiátrico do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Renato Alves
authors.initials: RA
authors.lastname: Higa
authors.affiliation: Department of Psychiatry, Círculo Psicanalítico do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Costa
mesh_terms: D001714:Bipolar Disorder / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D012559:Schizophrenia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy