Hashimoto’s thyroiditis presenting as acute psychosis with religious delusion: a case report

Hashimoto’s thyroiditis is the most common cause of hypothyroidism which can have psychiatric manifestation at first presentation which at times, may be so striking that patients are first diagnosed with a primary psychiatric disorder. We describe a case of 35 year old female patient who presented with acute psychosis with religious themed persecutory delusion. Further evaluation revealed a diagnosis of Hashimoto’s thyroiditis. Patient was started on thyroxin and olanzapine to which she responded and her psychosis resolved in two weeks. Olanzapine was reduced and stopped and, her thyroid function test at the end of three month was within normal range.