Psychoses associated with myxedema

Summary

The two cases reported represent the two general groups of mental illness associated with myxedema, one group in which myxedema appears to be the primary cause of the psychosis, the other in which myxedema is not directly related to the psychosis or may play only a secondary rôle.

In the first case, although the patient had suffered from a myxedematous mental state for a number of years, the psychotic symptoms had a rather sudden onset. They began as a delirious episode with subsequent partial amnesia for this episode, followed by a mild paranoid trend of relatively short duration. Both the physical and the mental symptoms on two different occasions, years apart, responded promptly to thyroid medication with complete remission of the mental illness.

In the second case, if the myxedema was in any way associated with mental illness it was only as one of the several contributory factors. The psychosis seems to have resulted primarily from maladjustment of a neurotic personality to difficult life situations.

The mental picture was that of a paranoid condition, which ran a continous course. Although the administration of thyroid in this case repeatedly relieved the physical symptoms of the myxedema, it had no material influence on the mental illness except perhaps for producing a slight reduction in the intensity of the symptoms.