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New Onset of Neuropsychiatric Symptoms in the Elderly: Possible Primary Hyperparathyroidism

Received Nov. 6, 2001; revision received March 8, 2002; accepted April 2, 2002. From the Department of Psychiatry, University of North Carolina at Chapel Hill. Address reprint requests to Dr. Watson, Robert Wood Johnson Clinical Scholars Program, UNC Department of Psychiatry, 5034 Old Clinic Building, Chapel Hill, NC 27599-7105; lea_watson{at}unc.edu (e-mail).

ABSTRACT

Primary hyperparathyroidism is a disorder of calcium homeostasis that occurs most commonly in older adults. Resultant hypercalcemia may be accompanied by neuropsychiatric symptoms, ranging from mild depression and cognitive changes to extreme agitation and psychosis. Surgical intervention almost invariably reverses these symptoms. The authors reviewed the importance of considering this diagnosis in the setting of neuropsychiatric symptoms in the elderly and reported on a 63-year-old man with mild hypercalcemia and a new onset of psychosis.

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