Psychiatric Morbidity in Drug-Naive Hypothyroid Patients.

Syed Ummar, I (2008) Psychiatric Morbidity in Drug-Naive Hypothyroid Patients. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Hypothyroidism results from inadequate production of thyroid hormone, And is classified as clinical or subclinical, depending on the degree of clinical Severity and the extent of abnormalities in thyroid indices. In overt or clinical Hypothyroidism, thyroid hormone levels are low, and TSH is elevated. Subclinical hypothyroidism describes a condition in which T3 and T4 levels are Normal but TSH is elevated, or the TSH response to TRH infusion is Exaggerated. The prevalence of clinical hypothyroidism is approximately 2% in Women and less than 0.1% in men. Subclinical hypothyroidism also Predominates in women, occuring in approximately 7.5% of women and 3% in Men. Elderly women are estimated to have upto 16% of subclinical Hypothyroidism. Hashimoto's thyroiditis is the most common cause of clinical Hypothyroidism. Other causes are idiopathic atrophy of thyroid gland, iodine Deficiency, hypopituitarism, iatrogenic hypothyroidism. Symptoms are cold Intolerance, constipation, muscle cramps, menstrual disturbances (amenorrhoea Or menorrhagia), weight gain, dyspnoea, husky voice, slowed dtrs, Bradycardia, cardiomegaly, dizziness, syncope, poor appetite, normocytic, Normochromic anemia. Psychiatric symptoms most commonly related to thyroid deficiency Include forgetfulness, fatigue, mental slowness, inattention and emotional Lability. The predominant affective disorder experienced is depression. Delusions and hallucinations may occur as the disease progresses. No Correlation, however, appears to exist between the degree of thyroid Dysfunction and psychiatric symptoms that subsequently develop. Depression has been the major affective illness described in hypothyroid Patients. Approximately 40% of clinically hypothyroid patients have significant Signs and symptoms of depression. Although the relationship between Subclinical hypothyroidism and depression remains controversial, a more Firmly established relationship exists between treatment resistant depression And subclinical hypothyroidism. A central serotonergic deficiency, brain catecholamine deficiency, Inhibition of type-II 5-deiodinase enzyme, a state of relative cerebral Hypothyroidism are the proposed hypotheses linking depressive symptoms in Hypothyroidism. Cognitive dysfunction also may be a result of hypothyroidism, most Commonly, psychomotor slowing, deficits in memory, visuoperceptual skills And constructional dexterity. Cognitive decline secondary to thyroid deficiency, May represent dementia, which is reversible with thyroxine replacement Therapy. Psychosis typically emerges after the onset of physical symptoms, often After a period of years or months. Manifestations include delusions (often Paranoid), visual or auditary hallucinations, perseveration, loosening of Association. These psychotic symptoms can occur without delirium or Dementia. The prevalence of major depression among hypothyroid patients is 33%- 43%, Anxiety disorder is 20%-33%, cognitive impairement 29% and Psychosis/delirium is 5%. This study focusses on psychiatric morbidity among hypothyroid Patients. Since correction of thyroid deficiency may reverse psychiatric Manifestations, drug-naive hypothyroid patients were included. Only adult Population were included in this study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Psychiatric Morbidity ; Drug-Naive ; Hypothyroid Patients.
Subjects: MEDICAL > Psychiatry
Depositing User: Subramani R
Date Deposited: 19 Aug 2017 03:03
Last Modified: 19 Aug 2017 03:03

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