INTRODUCTION
Severe thyroid dysfunction may mimic almost any psychiatric symptom profile.1, 2 even before the determination of serum thyroid hormone concentrations and before suppressive and substitutive thyroid therapies became widely available, and there are reports about psychopathological syndromes associated with thyroid dysfunction such as “myxoedematous madness.”1 Mild or latent thyroid dysfunction may be associated with more or less subtle psychiatric abnormalities.3
The prevalence of depression, anxiety disorders including panic disorder, simple phobia and obsessive-compulsive disorders is much higher in thyroid patients when compared to the general population. This suggests that the co-occurrence of psychiatric and thyroid diseases
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In an Indian study, it has been estimated that around 42 million people suffer from thyroid disorders. (Desai PM et al. 1997)6. In a population-based study conducted in Cochin, Kerala, on a total of 971 adult subjects, the prevalence of clinical hypothyroidism was estimated at 3.9%. The prevalence of subclinical hypothyroidism was estimated at 9.4%. The study also stated that prevalence of subclinical hypothyroidism increased with age. (Usha Menon V et al. 2007)7.
Studies in western population give an estimate of prevalence that is comparable to the Indian study. The Whickham survey, conducted in the Northern England, reported a mean incidence of 4•1/1000 per year for hypothyroidism in women. Several authors mention that the wide range in prevalence studies is due to inherent differences in age, gender, body-mass index (BMI), race, dietary iodine intake, and the cut-off serum TSH concentrations that are routinely used to define the condition. For example, most epidemiological surveys concur that the prevalence of mild thyroid dysfunction in the older people was clearly in excess of the prevalence in younger population (Cooper D et al.
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They reported no evidence for a common factor influencing both depression and life events. Kendler & Karkowski-Shuman (1997) showed that, in adults, negative life events were most likely to lead to the onset of major depressive disorder in individuals inferred to have a genetic liability to depression, and also that the genetic liability to depression overlaps with the genetic liability to experience stressful life events. So, through their behaviour, people can to some extent shape and select their