Psychosis resulting in suicide in a patient with primary hyperparathyroidism

A case is reported of a patient presenting to the psychiatric unit of our hospital with symptoms of depression and found to have an organic psychosis. On routine SMA-12 investigation (12 channel auto analyzer), elevated serum calcium was detected on admission leading to the diagnosis of primary hyperparathyroidism (PHPT). The surgical removal of a parathyroid adenoma was followed by a rapid return of biochemical abnormalities to normal ranges. In spite of appropriate psychiatric management and fluctuations in the patient's clinical condition, the organic psychosis was unaltered and culminated in suicide 4 months after admission.