Hypothyroidism and Neuropsychiatric Manifestations

Aim and background: Hypothyroidism is a common disorder with diverse presentations.Disturbance in thyroid hormones leads to a variety of neuropsychiatric manifestations, as these hormones are required for development and normal functioning of central nervous system.Materials and methods: Psychiatric assessment was carried out on 100 randomly selected newly diagnosed adult patients with hypothyroidism.All the patients were evaluated (following International Classification of Diseases, Tenth Revision criteria) for psychiatric manifestations, including major depression, generalized anxiety disorder, panic disorder, and mixed anxiety-depressive disorder, with the help of clinical psychiatric examination and present status examination questionnaire.The data obtained was compiled and analyzed statistically.Results: Out of 100, 54 patients were in subclinical range while 46 were suffering from overt or clinical hypothyroidism.A total of 54 patients were found to be suffering from depression; out of which 13 patients were having mild depression, 19 had moderate, and 22 patients were having severe depression.Among other psychiatric disorders, 14 were suffering from panic attacks, 15 from generalized anxiety, and 17 were found to be suffering from mixed anxiety and depressive disorder.Among different neuropsychiatric manifestations, the levels of triiodothyronine, free tetraiodothyronine, and thyroid-stimulating hormone were found statistically significantly different in severe depression and generalized anxiety only. Conclusion:There is an association of hypothyroidism and neuropsychiatric manifestations, out of which depression is the commonest.Clinical significance: All the patients of depression may be screened for thyroid dysfunction for their better management.