Myxedema psychosis: Clinical and biochemical changes during recovery

• Published in: Journal of psychiatric research Vol. 5; no. 4; pp. 289 - 296
• Main Authors: Treadway, C.R., Prange, A.J., Doehne, E.F., Edens, C.J., Whybrow, P.C.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.1967
• Subjects: 17-Hydroxycorticosteroids - urine; Adrenal Cortex Hormones - urine; Adrenal Glands - metabolism; Adult; Ankle; Catecholamines - urine; Epinephrine - urine; Female; Humans; Hypothyroidism - drug therapy; Mandelic Acids - urine; Myxedema - complications; Myxedema - metabolism; Norepinephrine - urine; Psychological Tests; Psychotic Disorders - complications; Psychotic Disorders - drug therapy; Psychotic Disorders - metabolism; Reaction Time; Reflex; Thyroid Hormones - therapeutic use
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/0022-3956(67)90017-9

A myxedematous patient with a panpsychotic reaction is described. Results of serial psychological testing, ankle reflex measurement and urinary catecholamine and 17-OHCS determinations are presented. As the patient gradually became euthyroid, mental disturbance, ankle reflex time, and urinary excretion of catecholamines and corticosteroids also gradually decreased. Thyroid hormone improved mental functioning before exerting major peripheral effects. Abnormally high urinary excretion of epinephrine and norepinephrine was similar to that described in psychotic depression and in acute schizophrenia and was apparently related to psychological distress. Normetanephrine levels were also elevated in contrast to the findings in psychotic depression. Corticosteroid levels were quite low despite severe psychological distress, probably as an effect of prolonged hypothyroidism on the adrenal cortex.