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[Psychiatric and cognitive aspects of hypothyroidism]
S N Bjerke1, T Bjøro, S Heyerdahl
1Psykiatrisk avdeling Sentralsykehuset i Akershus 1474 Nordbyhagen. synnovenessbjerke@hotmail.com
Background:
Diffuse and initial changes of behaviour, mood and cognition in hypothyroidism represent diagnostic and therapeutic challenges.
Material And Methods:
We present four cases and discuss relevant literature. Patients were followed from time of diagnosis through the first 6-12 months of thyroxine treatment. Symptoms were identified using interviews, questionnaires and tests.
Results:
The patients had reduced quality of life, depression, anxiety and impaired short time memory. All symptoms improved with thyroxine treatment, although patients did not necessarily reach premorbid functioning in 6-12 months. In the literature, depression in hypothyroidism is hypothesised to be at least partly caused by relative hypothyroidism in the central nervous system, and local brain triiodothyronine deficiency may be a possible explanation for affective and cognitive symptoms in subclinical hypothyroidism.
Interpretation:
Physicians should actively address psychiatric and cognitive aspects of hypothyroidism and in addition to thyroxine offer supportive treatment, especially to those depressed.