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Acute Mania in the Setting of Severe Hypothyroidism

Received May 10, 2004; revision received Oct. 20, 2004; accepted Nov. 15, 2004. From the Department of Psychiatry, New York-Presbyterian Hospital, Weill-Cornell Medical Center. Address correspondence and reprint requests to Dr. Stowell, Department of Psychiatry, New York Presbyterian Hospital, Weill-Cornell Medical Center, 525 East 68th St., New York, NY 10021; chs9017{at}nyp.org (e-mail).

Although the associations between depression and hypothyroidism and between mania and hyperthyroidism are well described, mania in the setting of hypothyroidism is unusual. The authors present the case of a patient whose acute mania appears to have been precipitated by hypothyroidism secondary to postpartum thyroiditis. This case underscores the importance of thyroid screening in patients with mood and psychotic disorders, including patients who lack the classical psychiatric features of thyroid dysfunction. Further investigation is required on the nature of the relationship between thyroid function and bipolar disorder and any implications it may have for the diagnosis and treatment of this illness.

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