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VOLUME 9 , ISSUE 1--3 ( January-December, 2024 ) > List of Articles

CASE REPORT

A Case Report Unveiling the Convergence of Mania and Hyperthyroidism in a Young Man: A Symphony of Discordance

Krutika J Mundra, Anubhuti Sharma, Sukriti Singh, Geetika Chopra, Manju Bhaskar

Keywords : Bipolar disorder, Case report, Grave's disease, Mania, Psychosis

Citation Information : Mundra KJ, Sharma A, Singh S, Chopra G, Bhaskar M. A Case Report Unveiling the Convergence of Mania and Hyperthyroidism in a Young Man: A Symphony of Discordance. J Mahatma Gandhi Univ Med Sci Tech 2024; 9 (1--3):1-4.

DOI: 10.5005/jp-journals-10057-0238

License: CC BY-NC 4.0

Published Online: 23-10-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: This case report delves into the intricate relationship between bipolar affective disorder (BD) and hyperthyroidism, presenting the case of a 28-year-old male experiencing a manic episode with psychotic features secondary to an unmanaged thyroid condition. Case description: A 28-year-old male presented with a 1-month history of hyperphagia, weight loss, diaphoresis, tremors, insomnia, hyperactivity, grandiosity. Past history revealed a similar episode resolving spontaneously. Mental status examination displayed elevated mood, labile affect, and delusions. Further investigations revealed hyperthyroidism. Initial management included antipsychotics, mood stabilizers, and a beta blocker. Conclusion: In conclusion, this case highlights the complex intertwining of hyperthyroidism and mania. While hyperthyroidism can mimic or exacerbate underlying bipolar disorder, the exact mechanisms remain under investigation. Studies suggest involvement of catecholamines, neurotransmitters, and inflammation. This case underscores the potential for hyperthyroidism to act as a trigger, particularly in individuals with a predisposition to mood disorders. Clinical significance: Psychosis is uncommon in Graves’ disease, despite its frequent symptoms like agitation and mood swings. A thyroid function test becomes crucial for individuals experiencing these or other psychiatric symptoms, such as delirium, to rule out underlying medical causes during initial screening. Likewise, when encountering new or recurring mental health conditions, inquiring about potential hypothyroidism or hyperthyroidism symptoms from both patients and caregivers is valuable.


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  1. Wiggins JL, Brotman MA, Adleman NE, et al. Neural correlates of irritability in disruptive mood dysregulation and bipolar disorders. Am J Psychiatry 2016;173(7):722–730. DOI: 10.1176/appi.ajp.2015.15060833
  2. Diagnostic and Statistical Manual—V.
  3. Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid 2012;18(6):988–1028. DOI: 10.4158/EP12280.GL
  4. Salvador J, Gutierrez G, Llavero M, et al. Endocrine disorders and psychiatric manifestations. Endocrinology and Systemic Diseases. 2021. pp. 311–345.
  5. Greer S, Parsons V. Schizophrenia-like psychosis in thyroid crisis. Br J Psychiatry 1968;114(516):1357–1362. DOI: 10.1192/bjp.114.516.1357
  6. Goyal MK, Yadav KS, Solanki RK. A study of thyroid profile in patients suffering from the first episode of mania: a cross-sectional study. Indian J Psychiatry 2021;63(4):395–399. DOI: 10.4103/psychiatry.IndianJPsychiatry_33_20
  7. Bipolar-thyroid disorders: a literature review and meta-analysis. J Clin Endocrinol Metab 2000;85(5):1014–1022.
  8. Mood disorders in patients with hyperthyroidism: a nationwide follow-up study. Br J Psychiatry 2009;195(3):209–214.
  9. Bipolar disorder and comorbid thyroid disorders: an epidemiological and clinical review. Bipolar Disord 2012;14(3):209–225.
  10. Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol 2018;8(9):251–269. DOI: 10.1177/2045125318769235
  11. Radhakrishnan R, Calvin S, Singh JK, et al. Thyroid dysfunction in major psychiatric disorders in a hospital based sample. Indian J Med Res 2013;138(6):888–893.
  12. Toloza FJ, Mao Y, Menon L, et al. Association of thyroid function with suicidal behavior: a systematic review and meta-analysis. Medicina 2021;57(7):714. DOI: 10.3390/medicina57070714
  13. Ferløv-Schwensen C, Brix TH, Hegedüs L. Death by suicide in Graves’ disease and Graves orbitopathy: a nationwide Danish register study. Thyroid. 2017;27(12):1475–80.
  14. Chakrabarti S. Thyroid functions and bipolar affective disorder. J Thyroid Res 2011;2011:306367. DOI: 10.4061/2011/306367
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