Neuropsychiatric manifestations are common among patients with thyroid dysfunctions. Depression and cognitive impairments are the most frequent symptoms of hypothyroidism. Few cases of mania associated with primary hypothyroidism were observed in the literature.

We report a case illustrating the association between the two diseases. A literature review was conducted through searches of PubMed and Medline.

Miss R, 35 years old, who had no previous history of psychiatric disorders, was admitted in 2014 with symptoms associated to acute manic episode (diagnosed using DSMIV).

Signs of florid hypothyroidism were noted at the exam and confirmed by biological tests.

Family revealed multinodular goiter surgical operation (in 2013) with poor adherence to thyroxin replacement. Both antipsychotic drugs, mood stabilizers and thyroxin replacement were required for his remission .

This case leads us to ask the following question: is it a fortuit comorbidity or does the mania is due to hypothyroidism?

According to the results of literature, hypothyroidism with manic presentation is not common (10 reports of mania consistent with primary hypothyroidism). While occurrence of mania in hyperthyroidism involves the beta adrenergic system, mechanisms underlying the occurrence of mania in hypothyroidism remains unclear. However, recent studies begin to provide a better understanding of the links between thyroid dysfunctions and mood disorders.

Psychiatric manifestations of hypothyroidism are various and lead to a better screening of thyroid dysfunctions, especially in patients with mood disorders