Endocrine Abstracts

Background: Hypothyroidism is a common disorder presenting with both somatic and psychiatric symptoms. Two cases of late onset psychosis are presented as an initial manifestation of myxedema.

Case presentation: 1. An 80-year old woman who had no past medical history presented with auditory and persecutory hallucinations. During her hospital stay she was found to have a decreased level of consciousness (GCS:4), and a blood investigation showed the presence of severe hypothyroidism. Following thyroid replacement therapy, the patient’s consciousness improved and she recovered from her psychosis.

2. A 38-year old woman with a known history of Hashimoto thyroiditis had stopped her treatment one year earlier presented disoriented with persecutory hallucinations. A blood analysis revealed severe hypothyroidism and was immediately treated accordingly. The patient showed immediate response and became cooperative and mentally stable.

Conclusions: Myxedema madness should be considered particularly in acute and late-onset psychosis as a possibly reversible condition with no need of long-term antipsychotics administration.