A case of paranoid disorder associated with hyperthyroidism

This paper describes a patient presenting with paranoid symptoms who eventually was diagnosed as having Graves' disease. In this patient, paranoid disorder appeared to occur concurrently with hyperthyroidism in a clear state of consciousness. This case underscores the need to maintain a high index of suspicion of possible medical conditions in psychiatric patients. This is especially the case in the presence of unexplained symptoms and when there is a difficulty communicating with the patient. The importance of carrying out a careful physical examination on admission to a psychiatric unit is emphasized. Another indication for further medical investigation in a patient with psychiatric symptoms is the absence of a psychological explanation for a worsening of the psychiatric symptoms.