A Case Report of Psychosis in a Patient of Myxedema: Myxedema Madness

Myxedema is one of the most important causes of organic psychosis and sometimes can be missed. There are some cases showing extreme degree of hypothyroidism leading to psychiatric illnesses like mania, depression and psychosis. In present case, a 21year old well-functioning female developed hypothyroidism initially with symptoms of Myxedema which was undiagnosed for 2 years. She had psychotic features after 2 years in form of hallucinatory behavior, poor self-care, persecutory and referential delusions, episodes of violent behavior and suicidal attempts. Thyroid supplementation was given in therapeutic dose but there was no improvement in her clinical profile. It was decided by experts to add antidepressant and antipsychotic medicines. Patient had marked improvement. She started talking with family, her aggression subsided. Only persecutory delusion and memory impairment persisted so doses of antipsychotic medicine was gradually built up. She showed marked improvement like she started taking self-care, and her affect improved. She was given discharge on request by relatives with marked improvement in psychosis though her thyroid profile was still not normal.