Treatment-resistant Bipolar Disorder and Thyroid Cancer
Introduction Bipolar disorder (BD) is a chronic and recurrent illness frequently associated with functional deterioration and treatment challenges. High rates of thyroid dysfunction have been found in patients with BD, compared to the general population. Objectives To illustrate through a case-rep...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822010483/type/journal_article |
| _version_ | 1797617034704453632 |
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| author | H. Jemli U. Ouali A. Aissa Y. Zgueb R. Jomli |
| author_facet | H. Jemli U. Ouali A. Aissa Y. Zgueb R. Jomli |
| author_sort | H. Jemli |
| collection | DOAJ |
| description |
Introduction
Bipolar disorder (BD) is a chronic and recurrent illness frequently associated with functional deterioration and treatment challenges. High rates of thyroid dysfunction have been found in patients with BD, compared to the general population.
Objectives
To illustrate through a case-report the therapeutic challenges of treatment-resistant bipolar disorder and its relationship with thyroid dysfunction.
Methods
Case report of a 41-year-old male patient with BD and comorbid anxiety disorders who has been diagnosed with thyroid cancer and underwent total thyroidectomy.
Results
Mr B is a 41 year old patient diagnosed with BD and comorbid anxiety disorders (panic disorder, social anxiety disorder and generalized anxiety disorder) at age 18. He has presented in total 17 relapses and was hospitalized 7 times between the ages of 18 and 24. He experienced predominantly major depressive episodes with mixed features and debilitating anxiety symptoms. He was put on several treatments including a combination of mood stabilizers, antidepressants and benzodiazepines. Due to unsatisfactory treatment response, he was put on clozapine 150mg to 175mg/d combined with valproic acid, clonazepam. In 2009, the patient developed a nodular goiter caused by papillary thyroid carcinoma and underwent total thyroidectomy and radioactive iodine therapy. Following the surgical operation and stabilization of thyroid functioning, a decrease in the number of relapses and the severity of mood and anxiety symptoms have been noted.
Conclusions
This case reports highlights the importance of thyroid function assessment in patients with bipolar disorder and the possible correlation to treatment resistance and symptom severity.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:49:46Z |
| format | Article |
| id | doaj.art-ee2087a8b85a43b79d41a03f1d22bb3a |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:49:46Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-ee2087a8b85a43b79d41a03f1d22bb3a2023-11-17T05:06:58ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S413S41310.1192/j.eurpsy.2022.1048Treatment-resistant Bipolar Disorder and Thyroid CancerH. Jemli0U. Ouali1A. Aissa2Y. Zgueb3R. Jomli4University of tunis elmanar, Faculty Of Medicine Of Tunis, manouba, TunisiaRazi Hospital, Psychiatry A, manouba, TunisiaRazi Hospital, Psychiatry A, manouba, TunisiaRazi Hospital, Psychiatry A, manouba, TunisiaRazi Hospital, Psychiatry A, manouba, Tunisia Introduction Bipolar disorder (BD) is a chronic and recurrent illness frequently associated with functional deterioration and treatment challenges. High rates of thyroid dysfunction have been found in patients with BD, compared to the general population. Objectives To illustrate through a case-report the therapeutic challenges of treatment-resistant bipolar disorder and its relationship with thyroid dysfunction. Methods Case report of a 41-year-old male patient with BD and comorbid anxiety disorders who has been diagnosed with thyroid cancer and underwent total thyroidectomy. Results Mr B is a 41 year old patient diagnosed with BD and comorbid anxiety disorders (panic disorder, social anxiety disorder and generalized anxiety disorder) at age 18. He has presented in total 17 relapses and was hospitalized 7 times between the ages of 18 and 24. He experienced predominantly major depressive episodes with mixed features and debilitating anxiety symptoms. He was put on several treatments including a combination of mood stabilizers, antidepressants and benzodiazepines. Due to unsatisfactory treatment response, he was put on clozapine 150mg to 175mg/d combined with valproic acid, clonazepam. In 2009, the patient developed a nodular goiter caused by papillary thyroid carcinoma and underwent total thyroidectomy and radioactive iodine therapy. Following the surgical operation and stabilization of thyroid functioning, a decrease in the number of relapses and the severity of mood and anxiety symptoms have been noted. Conclusions This case reports highlights the importance of thyroid function assessment in patients with bipolar disorder and the possible correlation to treatment resistance and symptom severity. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822010483/type/journal_articlebipolar disordersthyroid functionresistanceAnxiety disorders |
| spellingShingle | H. Jemli U. Ouali A. Aissa Y. Zgueb R. Jomli Treatment-resistant Bipolar Disorder and Thyroid Cancer European Psychiatry bipolar disorders thyroid function resistance Anxiety disorders |
| title | Treatment-resistant Bipolar Disorder and Thyroid Cancer |
| title_full | Treatment-resistant Bipolar Disorder and Thyroid Cancer |
| title_fullStr | Treatment-resistant Bipolar Disorder and Thyroid Cancer |
| title_full_unstemmed | Treatment-resistant Bipolar Disorder and Thyroid Cancer |
| title_short | Treatment-resistant Bipolar Disorder and Thyroid Cancer |
| title_sort | treatment resistant bipolar disorder and thyroid cancer |
| topic | bipolar disorders thyroid function resistance Anxiety disorders |
| url | https://www.cambridge.org/core/product/identifier/S0924933822010483/type/journal_article |
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