Summary
To investigate relationships between hyperthyroidism and behavior, 45 formerly hyperthyroid patients (now euthyroid) and 51 control subjects were investigated by (a) a semi-structured psychiatric examination, (b) self-rating scales to assess mood states and personality, and (c) neuropsychological tests. Patients with “subclinical” or “remitted” hyperthyroidism showed more abnormalities than the controls in all dimensions investigated. Forty-three percent of patients (10% of controls) complained of “seriously reduced” well-being with feelings of fear, hostility, and inability to concentrate. While a fearful-agitated syndrome dominated in the initial phase of the illness, a mainly depressive syndrome was characteristic after a longer period of remission. More than 25% of the patients (2% of controls) showed “markedly impaired” neuropsychological functioning. Patients with a relapse within 2.5 years exhibited the most abnormal results. Even after a longer period of hormonal remission, there was no complete psychopathological and neuropsychological normalization. A thorough follow-up of hyperthyroid patients is recommended.
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Abbreviations
- AMDP:
-
Association for Methodology and Documentation in Psychiatry
- MMPI:
-
Minnesota Multiphasic Personality Inventory
- POMS:
-
Profile of Mood Scale
- SDS:
-
Self-rating Depression Scale
- STAI:
-
State Trait Anxiety Inventory
- TBG:
-
Thyroxine Binding Globuline
- T3:
-
Trijodthyronine
- T4:
-
Thyroxine
- TSH:
-
Thyroid Stimulating Hormone
References
Artunkal S, Togrol S (1964) Psychological Studies in hyperthyroidism and in brain thyroid relationship. Little, Brown, Boston
Benton AL (1968) Differential behavioral effects in frontal lobe disease. Neuropsychologica 6:53–60
Benton AL (1981) Der Benton-Test. (In Dt. Bearbeitung O. Spreen.) Huber, Stuttgart
Chapuis F (1959) Der Labyrinth-Test. Huber, Stuttgart
Golden CJ (1976) Identification of brain disorders by the Stroop Color and Word Test. J Clin Psychol 32:621–630
Gordon NG (1972) The Trailmaking Test in neuropsychological diagnosis. J Clin Psychol 28:167–169
Kleinschmidt HJ, Waxenberg SE (1956) Psychophysiology and psychiatric management of thyrotoxicosis: a two year follow-up study. J Mount Sinai Hospital NY 23:131–153
Ladwig E (1978) Stellt die Behandlung mit östrogenen ein erhöhtes Strumarisiko dar? Universität München, Dissertationsschrift
Lezak MD (1983) Neuropsychological assessment. Oxford University Press, New York
Loosen PT (1986) Hormones of the hypothalamic-pituitary-thyroid axis: a psychoneuroendocrine perspective. Pharmacopsychiatry 19:401–415
MacCrimmon DJ, Wallace JE, Goldberg WM, Streiner DL (1979) Emotional disturbance and cognitive deficits in hyperthyroidism. Psychosom Med 41:331–340
McNair DM, Lorr M, Doppleman LF (1971) The profile of mood states (POMS), San Diego
Merz J, Lehrl S, Galster JV, Erzigkeit H (1975) MWT-Bein Intelligenzkurztest, Psychiatr Neurol Med Psychol 27:423–428
Morley JE, Shafer RB (1982) Thyroid function screening in new psychiatric admissions. Arch Intern Med 142:591–593
Perrild H, Hansen JM, Arnung K, Olsen PZ, Danielsen U (1986) Intellectual impairment after hyperthyroidism. Acta Endocrinol 112:185–191
Popkin MK, Mackenzie TB (1980) Psychiatric presentations of endocrine dysfunctions. In: Hall RCW (ed) Psychiatric manifestation of medical illness, Spectrum, New York, pp 142–143
Reitan RM (1955) Investigations of the validity of Halstead's measures of biological intelligence. Arch Neurol Psychiatry 73:28–35
Robbins LR, Vinson DB (1960) Objective psychological assessment of the thyrotoxic patient and the response to treatment: preliminary report. J Clin Endocrinol 20:120–129
Rockey PH, Griep RJ (1980) Behavioral dysfunction in hyperthyroidism. Arch Intern Med 140:1194–1197
Röckel M, Teuber J, Schmidt KR, Kaumeier S, Häfner H, Usadel K-H (1987) Korrelation einer “latenten Hyperthyreose” mit psychischen und somatischen Veränderungen. Klin Wochenschr 65:264–273
Spielberger CD, Gorsuch R, Lushene RE (1970) STAI, Manual for the State-Trait-Anxiety Inventory, Palo Alto
Taylor JW (1975) Depression in thyreotoxicosis. Am J Psychiatry 132:552–553
Trzepacz PT, McCue M, Klein I, Levey GS, Greenhouse J (1988) A psychiatric and neuropsychological study of patients with untreated Graves' disease. Gen Hosp Psychiatry 10:49–55
Wechsler D (1944) HAWIE: The measurement of adult intelligence. Williams & Wilkins, Baltimore
Whybrow PC (1983) Behavioral and psychiatric aspects. In: Ingbar SH, Braverman LE (EDS), Werner's Thyroid. Lippincott, Philadelphia, pp 967–973
Whybrow PC, Prange AJ, Tread way CR, Hill C (1969) Mental changes accompanying thyroid gland dysfunction. Arch Gen Psychiatr 20:48–63
Zeitlhofer J, Saletu B, Stary J, Ahmadi R (1984) Cerebral function in hyperthyroid patients. Neuropsychobiology 11:89–93
Zung WWK, Durham NC (1965) A self-rating depression scale. Arch Gen Psychiatr 12:63–70
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Dedicated to Professor Hanns Hippius on the occasion of his 65th birthday.
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Bommer, M., Eversmann, T., Pickardt, R. et al. Psychopathological and neuropsychological symptoms in patients with subclinical and remitted hyperthyroidism. Klin Wochenschr 68, 552–558 (1990). https://doi.org/10.1007/BF01667147
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DOI: https://doi.org/10.1007/BF01667147