Endocrine psychiatry (thyroid, Cushing, Addison)

Your progress

Saved on this device.

Target exams

Red flags

• Adrenal crisis (shock, hyponatraemia, hypoglycaemia, delirium) — give parenteral hydrocortisone and fluids; do not delay for psychiatric formulation
• Thyroid storm or severe thyrotoxic agitation with fever, tachycardia, and altered mental state — medical emergency pathway first
• New psychosis or mania within days of high-dose corticosteroids — treat as steroid neurotoxicity until proven otherwise; do not lock in lifelong bipolar without longitudinal evidence
• Severe untreated hypothyroidism with paranoia or delirium (myxoedema psychosis) — reverse thyroid failure with medical supervision; support safety
• Treatment-resistant depression with cushingoid features, unexplained hypokalaemia, or progressive cognitive change — screen for hypercortisolism with endocrinology
• Lithium without thyroid monitoring — both hypothyroidism and hyperthyroidism can occur
• Capacity for major decisions while organic psychosis, severe melancholic depression, or delirium is active