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The role of thyroid function on the occurrence and psychopathological exacerbation of delusional disorders: Two case studies and review of recent works.

Published online by Cambridge University Press:  19 July 2023

A. Guàrdia ,
A. González-Rodríguez ,
L. Lafuente ,
M. Natividad ,
E. Izquierdo ,
E. Roman  and
J. A. Monreal
A. Guàrdia*
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
A. González-Rodríguez
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
L. Lafuente
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
M. Natividad
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
E. Izquierdo
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
E. Roman
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
J. A. Monreal
Affiliation:
Psychiatry, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
*
*Corresponding author.

Abstract

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Introduction

Primary hypothyroidism has been extensively associated with the presence of depressive symptoms in major depressive and bipolar disorders; however, the association between psychosis and hypothyroidism has received less attention.

Objectives

We aimed to present two cases of patients with delusional disorder (DD) and hypothyroidism and review studies focused on this association.

Methods

(1)Two case studies of DD patients. (2)Narrative review on the association of hypothyroidism and psychosis by using PubMed database (2000-August 2022). Search terms: [Hypothyroidism AND (psychosis or delusional disorder)].

Results

Two case-studies. Case A: 58 year-old woman with DD who presented a worsening of psychotic symptoms in association with the occurrence of newly diagnosed hypothyroidism. Risperidone 1mg daily was initiated. A combination of levothyroxine 100 mcg/day and paroxetine 20mg/day was started. Case B: 51 year-old DD women with remission of delusional symptoms, who presented occurrence of depressive symptoms and panic attacks with agoraphobia. Olanzapine 5 mg/day and venlafaxine 225 mg/day were started combined with levothyroxine 75 mcg/day.

Review: From a total of 159 records, 52 studies described an association between psychosis and hypothyroidism. Most of the studies are focused on the Myxedema madness, treatment of psychosis with comorbid hypothyroidism, and the role of thyroid function on emerging psychoses. Others: intellectual disability, epilepsy, psychosis, asthma, diabetes and heart failure. Genetic associations of Xq13 gene, encoding for nuclear receptors of thyroid receptors, with psychosis.

Conclusions

Many questions pertaining to DD and thyroid function remain unanswered. Treatment of hormonal comorbidities may be associated with a clinical improvement of psychotic symptoms.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S1047
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 (https://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), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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