Hypothyroidism: an important diagnostic consideration for the psychiatrist

[...]approximately 40% of patients with clinical hypothyroidism have significant depressive symptoms.8 The connection between subclinical hypothyroidism and depressed mood is more controversial. [...]an array of psychotic symptoms, including delusions, visual and auditory hallucinations, paranoia, and thought disorders, have been reported secondary to hypothyroidism.17 Psychosis does not necessarily appear to be related to the severity of the thyroid dysfunction because psychosis has been reported in both clinical and subclinical hypothyroidism. 18 While psychosis can be the presenting symptom that brings a patient to clinical attention, it typically occurs late in the disease course.