Psychotic Symptoms in a Patient with Hashimoto’s Thyroditis

Objective: Psychopathological symptoms, depression, apathy, memory and sleep disorders, have been reported in patients with Hashimoto’s thyroiditis, but psychotic symptoms without psychiatric background are extremely rare.
Method: A 74 year male patient without previous psychiatric history was presented with acute psychotic symptoms to the emergency department and was hospitalized for three days.
Results: The laboratory profile showed the presence of high titer of serum thyroid antibodies (ANTI-TG>4000IU/ml, n.r.=0.0-115.0 IU/ml), high titer (corrected) of serum Anti-thyroid peroxidase antibodies (Α-TPO: 386.7 IU/ml, n.r.:0.34 IU/ml) and high Thyroidstimulating hormone TSH: 45.6μΙU/ml,n.r.:2.03-4.01μIU/ml, T4(Thyroxine =6.98μg/dL, (n.r.:5.10-14.10μg/dL), T3triiodothyronine=0.84ng/mL (n.r.:0.80-2.00ng/mL). The diagnosis of primary hypothyroidism was made due to Hashimoto’s thyroiditis.
Conclusion: Since psychiatric symptoms may be one of the earliest manifestations of hypothyroidism, they are often misdiagnosed as functional psychiatric disorders. This confusion can lead to delayed treatment.