Thyroid and Parathyroid Diseases and Psychiatric Disturbance

Different factors have stimulated the interest on the relationships between psychiatric conditions and endocrine disturbances in general and thyroid disease in particular (Lishman, 1998). Historically, several authors have speculated about the role of hormones and endocrine disorders in relation to psychiatric conditions, and important attention has been devoted to the role of hormones in relation to control and feedback processes in neural structures (Carroll et al. 1981). Psychiatric syndromes have consistently been described or documented in endocrine diseases (Lishman, 1998; Kathol, 2002) and may pose a real clinical challenge for psychiatrists working in general hospitals (liaison or psychosomatic psychiatrists), but the evidence in the literature to support his or her intervention is limited, according to modern criteria. The purpose of this chapter is primarily to review available data in relation to the characteristics and frequency of specific psychiatric syndromes in primary thyroid and parathyroid disturbances; issues of diagnosis and differential diagnosis; mechanisms of production of psychiatric symptomatology; and treatment issues, including response of psychiatric syndromes to treatment of the endocrinopathy and to psychotropic medication.