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Cited by 120Thyroid Disorders and TreatmentsOphthalmology and Eye DisordersThyroid and Parathyroid Surgery

A psychiatric and neuropsychological study of patients with untreated Graves' disease

Trzepacz, Paula T., McCue, Michael, Klein, Irwin, Levey, Gerald S., Greenhouse, Joel·1988·General Hospital Psychiatry
DOI 10.1016/0163-8343(88)90084-9
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Abstract

We studied 13 untreated Graves' disease subjects in a clinical research unit using endocrine, psychiatric, and neuropsychological assessments. We used SADS interviews, RDC, standardized symptom rating scales, and motor activity monitoring to update earlier studies and quantified psychiatric symptoms to elucidate any correlations between endocrine and psychiatric status. Nine of 13 subjects had major depression, 8/13 had generalized anxiety disorder, and 3/13 were hypomanic. Anxiety levels were much higher than in other hospitalized medical patients. Using a broad battery of neuropsychological testing, we found mild deficits in attention, memory, and complex problem solving that were consistent with previous studies of hyperthyroid patients. The severity of psychiatric symptoms could easily result in an inappropriate referral to a psychiatrist prior to the diagnosis of hyperthyroidism. The relationship between psychiatric symptoms and possible CNS effects of excess levels of thyroid hormone is discussed.

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Crossref · 10.1016/0163-8343(88)90084-9

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  • Hyperthyroidism can cause or worsen other conditions such as anxiety or depression, which in turn can further impair sleep and insomnia.

    “Additionally, hyperthyroidism can cause or worsen other conditions such as anxiety or depression, which in turn can further impair sleep and insomnia (6).”

    From Thyroid Dysfunction and Sleep Disorders (2021) · cites this paper as [6]

  • Measurable changes in basal metabolic rate, cardiovascular hemodynamics, and psychiatric and neuropsychological function can be present in mild thyrotoxicosis.

    “Measurable changes in basal metabolic rate, cardiovascular hemodynamics, and psychiatric and neuropsychological function can be present in mild thyrotoxicosis (29).”

    From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [29]

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Authors
Trzepacz, P. T., McCue, M., Klein, I., Levey, G. S., & Greenhouse, J.
Affiliations
  • University of Pittsburgh (US)
  • Carnegie Mellon University (US)
Corresponding author
Trzepacz, Paula T.
ORCID
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
1988-01
Volume
10
Issue
1
Pages
49-55
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/0163-8343(88)90084-9
OpenAlex
W2008845394
Cited by
120
References
39
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 9 · 2022: 1 · 2021: 7 · 2020: 1 · 2019: 5 · 2018: 3 · 2017: 1 · 2016: 7 · 2015: 4 · 2014: 6 · 2013: 6 · 2012: 2
FWCI
2.49
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
Graves' disease, hyperthyroidism, untreated hyperthyroidism, major depressive disorder, generalized anxiety disorder, hypomania, neuropsychological deficits, attention deficits, memory impairment, complex problem solving, psychiatric referral
MeSH terms
Adult, Anxiety Disorders, Female, Graves Disease, Humans, Hyperthyroidism, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychometrics, Thyroid Function Tests, Neurocognitive Disorders

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