Late-onset mania with psychosis associated with hypothyroidism in an elderly Chinese lady

Tor PC, Lee HY, Fones CSL
Correspondence: Dr Tor Phern Chern, torphernchern@gmail.com

ABSTRACT
Late-onset bipolar disorder is rare and can be precipitated by organic brain disorders. While the association between hyperthyroidism and mania is well described, mania or hypomania precipitated by hypothyroidism is rare. The authors present late-onset bipolar disorder in a 72-year-old woman presenting with mania and psychosis, which appear to have been precipitated by autoimmune hypothyroidism. This case shows the importance of ascertaining the thyroid status in patients with mood and psychotic disorders, especially in elderly patients and in patients lacking prominent signs of thyroid disease.

Keywords: bipolar disorder, hypothyroidism, mania, psychosis, quetiapine
Singapore Med J 2007; 48(4): 354–357