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Close liaison between psychiatry and endocrinology services was essential. This demonstrates that treating underlying thyrotoxicosis in patients presenting with psychiatric symptoms may lead to recovery without the use of antipsychotic medication. While agitation, irritability and mood lability are well-recognised thyrotoxic symptoms, psychosis is a rare presenting feature of Graves\u2019 disease. All patients with agitation, delirium or psychiatric symptoms should have thyroid function checked as part of initial tests screening for organic disease. In new or relapsing psychiatric conditions, it is important to ask patients, their carers or relatives about symptoms of hypothyroidism or thyrotoxicosis.<\/jats:p>","DOI":"10.1136\/bcr-2020-236089","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T17:32:06Z","timestamp":1612891926000},"page":"e236089","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Graves\u2019 disease presenting with hypomania and paranoia to the acute psychiatry service"],"prefix":"10.1136","volume":"14","author":[{"given":"Benjamin","family":"Bennett","sequence":"first","affiliation":[{"name":"Endocrinology Department, Royal Free London NHS Foundation Trust, Herts, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Mansingh","sequence":"additional","affiliation":[{"name":"Springwell Centre, Barnet Enfield and Haringey Mental Health NHS Trust, Herts, 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