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Myxedema Psychosis: Systematic Review and Pooled Analysis
Mouhand F H Mohamed1,2, Mohammed Danjuma1,3, Mohammed Mohammed4
1Department of Medicine, Hamad Medical Corporation, Doha, Qatar.
Neuropsychiatric Disease and Treatment
|August 27, 2021
Summary
Myxedema psychosis (MP) involves psychotic symptoms in hypothyroidism patients. Early screening for thyroid dysfunction is crucial, as treatment with thyroxine leads to over 90% recovery in these cases.
Area of Science:
- Endocrinology
- Psychiatry
- Systematic Review
Background:
- Myxedema psychosis (MP) describes psychotic symptoms in untreated hypothyroidism.
- Optimal assessment and treatment strategies for MP remain unclear.
Purpose of the Study:
- To characterize the clinical presentation and management of myxedema psychosis.
- To synthesize existing literature on MP through a systematic review.
Main Methods:
- Systematic review of case reports and observational studies (1980-2019).
- Searched PubMed, Embase, Google Scholar, and Cochrane databases.
- Data synthesis using descriptive and inferential statistics.
Main Results:
- 75 MP cases analyzed; median age 42, 53% undiagnosed hypothyroidism.
- Delusions (91%) and hallucinations (78%) were common; physical signs absent in 26%.
- Thyroxine treatment with antipsychotics yielded >90% recovery; IV therapy showed a trend for shorter psychosis duration.
Conclusions:
- MP presents with diverse psychiatric and physical symptoms.
- Screening for thyroid dysfunction is valuable in first-episode psychosis.
- Further research is needed due to a lack of published data.
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