Citation

Todorov L, Boudaoud AA, De Raykeer RP, Radu A, Lahlou-Laforêt K, Limosin F, Lemogne C, Czernichow S. Case Rep. Psychiatry 2019; 2019.

Copyright

(Copyright © 2019, Hindawi Publishing)

DOI

10.1155/2019/4972760

PMID

unavailable

Abstract

Introduction. Hypothyroidism has been associatedwith mood disorders but some cases of acute psychosis have also been reported. However, less attention has been paid to suicidal behavior in these patients. Case Report. We report a case of suicide attempt by self-stabbing in a 43-year-old woman without past psychiatric history, fourmonths after radioiodine therapy for Graves' disease.On clinical examination remarkable signs ofmyxedemawere found and blood investigations showed hypothyroidismwith an extremely high thyroid stimulating hormone (TSH) level (152 mUI/L; reference range 0.20-5.10). The patient presented delirium symptoms at the time of self-stabbing, which was associated with persecutory delusions and auditory harm command hallucinations. A rapid physical and psychiatric improvement was observed after the initiation of an oral thyroid replacement therapywithout relapse after early discontinuation of the antipsychotic treatment.

DISCUSSION.The most distinctive feature of our case is that the violent suicide attempt could be attributed to the myxedema psychosis. Suicide may result from several factors, including psychosocial stressors, psychiatric symptoms, and hormonal disturbance.This unique presentation should remind clinicians to systematically consider ordering additional tests in patients with atypical psychiatric presentation, even when serious behavioral disorders (such as violent suicide attempts) are present and may result in premature transfer to psychiatric units. © 2019 Louise Todorov et al.

Language: en