ReviewNeuropsychiatric disease and treatment2021
Myxedema Psychosis: Systematic Review and Pooled Analysis.
Review in Neuropsychiatric disease and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- A Rare Presentation of Severe Hypothyroidism With Catatonia and Psychosis: Myxedema Madness.Cureus · 2026Article
- Hypothyroidism-Induced Psychotic Disorder with Prolonged Antipsychotic Treatment: A Case Report.Consortium psychiatricum · 2026Article
- Psychosis with untreated hypothyroidism: How a generalist made a difference.Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2026Article
- Autoimmune neuropsychiatric disorders manifesting with psychosis.The Journal of clinical investigation · 2025Review
- Clinical course of myxedema coma in an Alzheimer's disease patient and co-founding of J wave: A case report.Journal of family medicine and primary care · 2025Article
- Article
- Myxedema Psychosis: Diagnostic Challenges and Management Strategies in Hypothyroidism-Induced Psychosis.Cureus · 2024Article
- Sustained remission of psychotic symptoms secondary to hypothyroidism (myxedema psychosis) after 6 months of treatment primarily with levothyroxine: a case report.Journal of medical case reports · 2022Article
- First Episode Psychosis and Pituitary Hyperplasia in a Patient With Untreated Hashimoto's Thyroiditis: A Case Report.Frontiers in psychiatry · 2022Article
- Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report.Case reports in oncologyArticle
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveThe term myxedema psychosis (MP) was introduced to describe the occurrence of psychotic symptoms in patients with untreated hypothyroidism, but the optimal assessment and treatment of this condition are unclear. We aimed to synthesize data from the literature to characterize the clinical presentation and management of MP.
methodsWe performed a systematic review according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines in PubMed (Medline), Embase, Google Scholar, and Cochrane databases, including observational studies, case series, and case reports published from 1/1/1980 to 31/12/2019 in the English language. Descriptive statistics along with univariate and multivariate analysis were used for data synthesis.
resultsOut of 1583 articles screened, 71 case reports met our inclusion criteria providing data on 75 MP cases. The median age at diagnosis was 42 years [32-56]. About 53% had no prior hypothyroidism diagnosis. Delusions occurred in 91%, with a predominance of persecutory ideas (84%), while hallucinations occurred in 78%. Physical symptoms and signs of hypothyroidism were absent in 37% and 26%, respectively. If symptoms occurred, nonspecific fatigue was seen most frequently (63%). The median thyroid-stimulating hormone value was 93 mIU/L [60-139]. Thyroid peroxidase antibodies were found positive in 75% (23/33) of reported cases. Creatinine kinase was reported abnormal in seven cases. Cranial imaging (CT or MRI) and electroencephalogram were normal in 89%, 75%, and 73% of the cases reported. The majority of patients were treated orally with thyroxine in combination with short-term antipsychotics. More than 90% of them showed complete recovery. Univariate analysis revealed a trend towards a shorter duration of psychosis with IV thyroid hormone therapy (
conclusionWhile we identified a substantial lack of published research on MP, our pooled analysis of case observations suggests that the condition presents a broad spectrum of psychiatric and physical symptoms lending support to the value of screening for thyroid dysfunction in patients with first-ever psychosis. PROSPERO REGISTRATION NUMBER: CRD42020160310.
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