{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:42:57Z","timestamp":1791430977867,"version":"4.3.3"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>Psychotic syndromes in the context of hyperthyroidism are seldom mentioned in medical textbooks and only a few cases have been published. Typically, such cases present as an affective psychosis. Schizophrenia-like psychosis is a rare occurrence in hyperthyroidism and the link between these two conditions is still poorly understood.<\/jats:p><jats:p>We report the case of a female patient with a known history of chronic lymphocytic thyroiditis. The patient presented to our emergency department with an acute schizophrenia-like psychosis. Elevated levels of T4 and free T4 were found. These resulted from the patient\u2019s voluntary intake of excess levothyroxine as an attempt to lose weight (thyrotoxicosis factitia). Normalisation of thyroid hormone levels and antipsychotic treatment led to prompt remission of the psychosis. Even though the patient stopped the antipsychotics, she remained free of symptoms during the follow-up. Similar cases are briefly reviewed and some of the data from basic research is also considered.<\/jats:p>","DOI":"10.1136\/bcr.08.2008.0676","type":"journal-article","created":{"date-parts":[[2009,3,17]],"date-time":"2009-03-17T19:41:52Z","timestamp":1237318912000},"page":"bcr0820080676","source":"Crossref","is-referenced-by-count":5,"title":["Acute psychotic episode in a patient with thyrotoxicosis factitia"],"prefix":"10.1136","volume":"2009","author":[{"given":"Joaquim Alves","family":"da Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime Tra\u00e7a","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo Barahona","family":"Corr\u00eaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Narig\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Xavier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,3,17]]},"reference":[{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8627(05)70122-X"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0033-3182(83)73255-X","article-title":"Psychiatric effects of thyroid hormone disturbance","volume":"24","author":"Hall","year":"1983","journal-title":"Psychosomatics"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.3","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010228"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.4","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1080\/07435809009107116","article-title":"Thyroid hormone elevations during acute psychiatric illness: relationship to severity and distinction from hyperthyroidism","volume":"16","author":"Roca","year":"1990","journal-title":"Endocr Res"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.5","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1420438"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.6","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/BF03350892","article-title":"The age of patients with thyrotoxicosis factitia in Italy from 1973 to 1996","volume":"22","author":"Bogazzi","year":"1999","journal-title":"J Endocrinol Invest"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5857.35"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00115-003-1547-9"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.9","doi-asserted-by":"publisher","DOI":"10.1016\/0163-8343(86)90061-7"},{"key":"2025042507370976000_2009.mar08_1.bcr0820080676.10","first-page":"243","article-title":"Diagnostic significance of Schneider\u2019s first-rank symptoms in schizophrenia. 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