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Published Online: March 1942

PSYCHOSES AND ALLIED STATES OCCURRING SUBSEQUENT TO THYROIDECTOMY

MERLE Q. HOWARD and LLOYD H. ZIEGLERAuthors Info & Affiliations

Publication: American Journal of Psychiatry

Volume 98, Number 5

https://doi.org/10.1176/ajp.98.5.745

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Abstract

1. The histories of 70 thyroidectomized patients admitted to the Milwaukee Sanitarium in 16¼ years were studied. Clinical data regarding age, sex, residence, occupation, facts before and after thyroidectomy, including Sanitarium residence, are presented.

2. Their psychiatric disorders were chiefly of a functional nature (depression, elation, neurotic) in contrast to psychoses (delirious, exhaustive) usually seen in acute hyperthyroidism.

3. The evidence for acute postoperative delirious or exhaustion states was very slight in the group.

4. There were no cases of myxedema diagnosed by a consulting internist who examined all patients.

5. The prevalence of recurring attacks of psychiatric disorder before and after thyroidectomy makes the coincidence of toxic goiter and such states open to question. It is very probable that in some patients a psychiatric disorder was interpreted as the manifestations of toxic goiter.

6. It seems probable that thyroidectomy has been employed to treat recurring psychiatric disorders and with success because of its shock inducing effect.

7. Toxic goiter has been seen to develop in the course of a profound psychosis of a chronic nature and thyroidectomy was without effect on the psychosis.

8. Whether toxic goiter predisposes to degeneration of the nervous system, or to a deterioration in the functions of a person, is not known. Earlier senility and arteriosclerosis have been suspected.

9. In the study of these patients there seemed to be no positive evidence that emotional states cause hyperthyroidism.

10. The history of a patient who became psychotic and suicidal on the eve of thyroidectomy is presented with differential diagnosis. The patient recovered with electro-shock and psychotherapy during the course of which his supposedly elevated metabolic rate returned to normal.

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Information & Authors

Information

Published In

American Journal of Psychiatry

Volume 98 • Number 5 • March 1942

Pages: 745 - 749

History

Published in print: March 1942

Published online: 1 April 2006

Authors

Affiliations

MERLE Q. HOWARD

Milwaukee Sanitarium, Wauwatosa, Wisc.

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LLOYD H. ZIEGLER

Milwaukee Sanitarium, Wauwatosa, Wisc.

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PSYCHOSES AND ALLIED STATES OCCURRING SUBSEQUENT TO THYROIDECTOMY

Abstract

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