조증과 유사한 갑상선기능항진증 1례

A Case of Hyperthyroidism Simulating Mania

The psychiatric symptoms produced by hyperthyroidism are less clearly defined than those occured with myxedema. The typical psychiatric syndrome of hyperthyroidism is reported by most authors to simulate a bipolar disorder. Other forms reported were simple, catatonic and paranoid schizophrenia; psychotic depression; functional psychosis; organic brain syndrome; and atypical psychosis. No clear picture, however, exists concerning any fixed psychotic syndrome. Sometimes the patient become delirious while other times experience of hyperexcitability simulating mania that is quite confusing for the clinician to differentiate from bipolar disorder. The authors experienced a case of hyperthyroidism simulating bipolar disorder. The case was a 49-year-old male patient who developed a episode of delirium and manic symptoms during treatment of hyperthyroidism. Although mania is directly associated with thyroid hormone level, this case is not considered primary bipolar disorder because of close proximity between onset of hyperthyroidism and manic episode. Absence of past history and family loading for the bipolar disorder further support its relationship with hyperthyroidism. We considered that this patient s course of illness is embarrassing for there is a episode of delirium as well as manic symptoms. Psychiatrists should be aware of psychiatric syndromes including bipolar disorders associated with hyperthyroidism.