Graves’ disease and mental disorders
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Psychosocial factors including stress have been associated with mental symptoms even after thyroid function normalization in Graves’ disease and a combination of mental disorders have been related to the exacerbation of hyperthyroidism.

These findings suggest that psychosomatic approaches based on the bio-psycho-social medical model are important for the treatment of mental disorders associated with Graves’ disease.

As the terms “Basedow psychosis” and “myxoedema psychosis” indicate, it is known that mental disorders merge highly with thyroid diseases. These conditions are equivalent to the “symptomatic psychosis” indicated in psychiatry. However, many biases exist, because only patients with potential mental conditions and who were introduced to psychiatry were previously targeted.

It has been recently shown that mental symptoms accompany all inpatient and outpatient medical diseases. Previous research investigating the association of depression with medical conditions have indicated that hypothyroidism and hyperthyroidism show a 56% and 31% merging rate, respectively. On the other hand, it has been shown that abnormalities in the thyroid test values occur during depression, indicating a merge with the hypothalamus pituitary thyroid axis (HPT axis), and are correlated with the state of the illness. We also found that a depressed merger was related to the aggravation of Graves’ hyperthyroidism. Bidirectional causality is thought to be present between depression and thyroid.

Many researchers have studied the causality between thyroid and mental disorders, focusing on depression and anxiety. However, almost all of these studies were based on the biomedical model that considers only the biological factors associated with the thyroid hormones. In this review article, the etiology and treatment of mental disorders associated with Graves’ disease (GD) using the bio-psycho-social medical model are outlined.

Source: https://www.sciencedirect.com/science/article/pii/S2214623718301625
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