[Severe depressive episode with psychotic symptoms on the basis of hypothyroidism].

The prevalence of depressive disorders in hypothyroidism is the subject of long-term studies and controversies. The studies on big populations appear to confirm a substantially higher prevalence rate of depression in patients diagnosed with hypothyroidism. Considering interdependence between depression and hypothyroidism the possibility of coincidence of the two disorders cannot be forgotten. The aim of the work is a case of late diagnosed hypothyroidism in the course of which a severe depressive episode with psychotic symptoms occurred. A female patient, aged 39, commenced outpatient psychiatric treatment because of sleeplessness in May 2008. In the following months a lack of appetite, skin dryness and hair loss occurred. As a result of hypothyroidism diagnose she started endocrinological treatment in the Center of Thyroid Illness Treatment in Rzeszów. On the 25th of October she was admitted to Psychiatry Department of the Medical University of Lublin after taking clorazepate as a suicide attempt. While being admitted she was heavily depressed, uttered nihilistic delusions, had suicidal thoughts and was disoriented for time. From etiological point of view the situation can be considered in two categories. On one hand psychotic symptoms may have been the climax of the disturbance of the central nervous system function in long-lasting undiagnosed hypothyroidism. On the other hand, the coincidence of the two disorders cannot be excluded. The presented case implicate the role of the early diagnose of hypothyroidism for the prevention of depression.