Neuropsychiatric Manifestations of Thyroid Diseases.
Level 5 - mechanism / opinion, no new human data
Narrative literature review without systematic review methodology or meta-analysis
PubMed 36811059 · doi:10.7759/cureus.33987
What was done
The authors conducted a narrative literature search in PubMed covering literature from the previous 50–60 years to review neuropsychiatric manifestations associated with thyroid disorders in adult populations. The review examined pathophysiological mechanisms, cognitive impairment, depressive and anxiety disorders, mania, dementia, and Hashimoto encephalopathy in relation to hypothyroidism, hyperthyroidism, Graves' disease, and circulating thyroid-stimulating hormone (TSH) and free thyroxine (T4) levels.
What was found
The abstract reports no quantitative data, sample sizes, or numerical effect estimates. Qualitatively, hypothyroidism is reported to be associated with depression and mania, while hyperthyroidism is linked with dementia and mania. Graves' disease is linked with depressive and anxiety disorders. Subclinical hyperthyroidism, low TSH levels, and elevated free T4 are noted to increase the risk of dementia in older adults, though the specific mechanisms directly accelerating dementia onset remain unestablished.
Why it matters
This review aggregates known clinical associations between endocrine dysfunction and psychiatric pathology, underscoring the necessity of evaluating thyroid panels when diagnosing or managing mood disorders, mania, and cognitive decline.
Limits
The abstract does not report quantitative metrics, search selection criteria, or the total number of studies included. As a narrative review, it lacks formal systematic screening, risk-of-bias assessment, and meta-analytic synthesis, and precise causal mechanisms linking hyperthyroidism to dementia progression remain unverified.
Cited by
- supports Excess thyroid hormone (hyperthyroidism) causes irritability and cognitive deficits, while deficient thyroid hormone (hypothyroidism) can impair cognition severely enough to mimic dementia.