Thyroid Disease and Psychiatric Symptoms

Psychiatric Symptoms and Conditions in Thyroid Disease

Studies show an increased prevalence of psychiatric disorders and symptoms in patients with autoimmune thyroid disease and euthyroid goiter.

Incidence

Several large studies have shown a higher prevalence of psychiatric symptoms and psychiatric disorders in patients with autoimmune thyroid diseases and euthyroid (normal thyroid function) goiter than that observed in the normal population.
Overall, higher rates of panic disorder, simple phobia, obsessive-compulsive disorder, major depressive disorder, bipolar disorder, depression and cyclothymia (condition of alternating periods of depression and expansiveness/irritability/hallucinations) are seen in patients with thyroid dysfunction even when they are receiving appropriate treatment for their condition. Psychiatric diagnoses in these studies were based on standard DS IV criteria using the International Composite Diagnostic Interview, Simplified.

Effects of Thyroid Hormone

Thyroid hormone has a potent affect on disposition, mood, and cognition, and even slight changes in thyroid hormone levels can affect one's psyche. Abrupt changes in thyroid hormone levels, such as those resulting from ablative treatments for hyperthyroidism are known to cause symptoms that progress to psychosis.

Depression and Obsession

Depression is seen in both hyperthyroidism and hypothyroidism, but it is much more common in patients with Hashimoto's thyroiditis, a disorder of autoimmune hypothyroidism. Patients with Hashimoto's disease were more likely to have high frequencies of lifetime Depressive Episodes, Generalized Anxiety Disorders, Social Phobia, and Primary Sleep Disorders and they were shown to have a tendency towards an increased frequency of Panic Disorders. In addition, hypothyroidism has long been associated with obsessive disorders (Psychiatric Diagnosis, 4th Edition, DSM-IIIR). And although anxiety and mood disorders more often associated with hyperthyroidism, they're common features of hypothyroidism and may be evident before thyroid dysfunction becomes obvious.

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Symptoms

Patients with Graves' disease often have symptoms of anxiety, nervousness, fluctuating moods and irritability that resolve when thyroid hormone levels return to the normal range. Patients who are overmedicated on anti-thyroid drugs or who become permanently hypothyroid as a result of treatment often complain of the same conditions seen in patients with Hashimoto's thyroiditis.