Thyrotoxic psychosis in an elderly woman and haloperidol use: a case report.

Thyrotoxic patients may occasionally present with affective disorders. Here, we discuss a case of a 61-year-old woman with misidentification and persecutory delusions, olfactory hallucinations, and apathy associated with thyrotoxicosis. After definitive antithyroid and antipsychotic agent haloperidol treatments, the patient was released within 4 weeks. Thyrotoxic psychosis with apathy is a rare entity that can be misdiagnosed as affective psychosis. Haloperidol may be an alternative treatment in resolving psychotic features beside the treatment of hyperthyroid state.

Anxiety and depression in COPD patients and correlation with sputum and BAL cytology.

BACKGROUND AND AIMS: Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD). The degree of lung function may not explain anxiety and depression. The aim of our study was to assess the psychological aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capacity), and to evaluate the association between atypical cytologic findings of sputum, bronchoalveolar lavage (BAL) and the pyschological components of the disease. METHODS: COPD was classsified according to the GOLD stages based on forced expiratory volume in 1 second (FEV1) in 60 stable patients. The BODE index was calculated for grading COPD. The Hospital anxiety and depression (HAD) scale was used to appraise the anxiety and depression symptoms. Cytologic examination of sputum and BAL samples were performed in each patient. The cytologic findings were classified as normal, mild, moderate or severe atypia. RESULTS: The overall prevalance of anxiety and depression symptoms was 41.7% and 46.7% respectively. The prevalance of these symptoms increased with increasing BODE stages and correlated well with the severity of atypical BAL cytology results (p < 0.001). Dyspnea and reduced exercise capacity were the predominant mechanisms leading to anxiety and depression symptoms associated with COPD. CONCLUSIONS: We conclude that the BODE index is superior to GOLD stratification for explaining anxiety and depression symptoms in COPD. BAL cytologic findings, which reflect the distal parenchymal lung structure, correlated significantly with the presence of the anxiety and depression symptoms.

Depression and sex hormones in elderly women.

We aimed to study the relation between sex hormones and depression among elderly women. The study was carried out on 74 volunteered female subjects above 60 years of age. Each subject was asked to fulfill the geriatric depression scale (GDS) questionnaire and further evaluated for clinical depression by a psychiatrist using the DSM IV diagnostic criteria. For statistical analysis, subjects were later divided in two groups, according to the presence of clinical depression. Cognitive functions were assessed with the standardized mini mental test (SMMT). Disability in the activities of daily living was assessed with instrumental activities of daily living (IADL) scale. Plasma levels of estrogen, testosterone, progesterone, and dehydroepiandrosterone sulfate (DHEA-S) were measured with chemiluminescent methods, and plasma levels of androstenedione were measured with radioimmunoassay. Among 74 subjects, 34 (39%) had clinical depression. Age, number of years spent in education, SMMT scores, and IADL scores did not differ between the depressive and non-depressive groups. Plasma sex hormone levels were not found to be different between the two groups.