An assessment of psychiatric disturbances in Graves disease in a medical college in eastern India.

BACKGROUND Graves' disease is a unique conglomeration of cardiovascular, neurological, ophthalmological, and other systemic manifestations. In this study we have tried to explore the psychiatric dimensions of this disease. AIMS This study attempted to explore clinical features, types, and treatment outcome of psychiatric disturbances in Graves disease. STUDY DESIGN This is a purposive study following the criteria of DSM IV. MATERIALS AND METHODS A total of 36 adult patients of newly diagnosed Graves disease and 30 age- and sex-matched controls were included. Data enumerated were age, sex, date of admission, analysis of psychiatric signs, and symptoms by one independent observer, diagnostic categorization, effect of treatment, and outcome. Follow-up evaluation was done after 1 year. Statistical Analysis : Statistical analysis was done by the standard error of difference, the chi-square test, and paired Student's T-test. RESULTS Among 36 patients 32 were female and 4 were male. Fifteen patients (41.67%) were diagnosed with generalized anxiety disorders (GAD), 6 (16.67%) with mood disorder, 6 (16.67%) with obsessive compulsive disorder (OCD), and 2 each with personality disorder and schizophreniform disorder. The common symptoms were insomnia, irritability, and anxiety. The frequency of GAD was statistically more significant in the Graves disease group in comparison to control. Fourteen patients agreed to take both antithyroid and antipsychotropic medications (group 1). The rest were treated with only antithyroid drug (group 2). There was significant improvement in both groups and no difference between the groups. CONCLUSION The prevalence of certain psychiatric manifestations in Graves' disease was significantly higher than in the control group. There was no significant difference between therapy with antithyroid drugs and combination of antithyroid with psychotropic medications.